Expresion of Interest
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EXPRESION OF INTEREST COMMUNITY REFERENCE GROUP North Bannister Resource Recovery Park
Please complete all sections below and return to: Shay Menyweather [email protected]
Individual: Surname First Name Street/PO Box: Postal Address Suburb: P/C: Telephone H: W: M: Email Specific Area of Interest Environmental* Economic / Business / Community / Social* (please provide brief Employment* description of interest / issue)
Community / Business Organisation: Note : If representing an organisation, please attach a letter of authorisation supporting your nomination. Organisation Street/PO Box Postal Address Suburb: P/C: Website Email Nominated Role in Name: Representative Organisation: Telephone H: W: M: Email Substitute Role in Name: Representative Organisation: Telephone H: W: M: Email Specific Area of Interest Environmental* Economic / Business / Community / Social* (please provide brief Employment* description of interest / issue)
*If not enough space is available for description, please attach separate sheet of paper. July 2017 All Applicants: Describe you / your organisation’s expectations regarding participation in Community Reference Group:
If your application is unsuccessful, would you / your organisation be willing to Yes No participate in an Advisory Group relevant to your specific area of interest? Are you / is your organisation willing and able to:
Participate cooperatively in and constructively contribute to discussion on issues relevant to the future of the SUEZ North Bannister Resource Yes No Recovery Park Provide representation on behalf of an organisation and / or the general population and be willing to communicate CRG activities, SUEZ news and Yes No plans to your organisation or community? Treat all other CRG members and their views respectfully? Yes No Demonstrate the intention and ability to proactively represent community Yes No interests and enhance effective planning for the future of SUEZ? Volunteer time to represent community interests? Yes No Abide by the Community Reference Group Terms of Reference? Yes No
Individual: Signature:
Date:
Community / Business Organisation: Signature:
Print Name:
Position in Organisation:
Letter of Authority attached: Yes No
July 2017