EOI - ICSA

Expression of Interest

Join ICSA
CONTACT INFORMATION

Your details will be kept private and used only in the operations of ICSA and the delivery of our programs. We do not sell our contact data nor share privacy details with any other organisation. When working on collaborative projects, we may need to share your contact details, in such situations we will seek your consent prior to any detail being shared.
Name*
Date of Birth*

DayMonthYear
Date
Address*
State*
Post Code*
If you are outside Australia - enter OSEAS
Contact Phone*

Area CodePhone Number
E Mail Address*
example@example.com
Expression of Interest for*
What role are you interested in?

STUDENT

Expression of Interest
Education Institution*
Study Course*
What are you studying
Which year of study are you in?*
The current study year
Placement Hours*
How many hours will you need for this placement?
Start Date

DayMonthYear
Date
End Date

DayMonthYear
Date
Please provide details of your other commitments to be considered during the placement such as attending study, supervision or paid work.
Monday
Tuesday
Wednesday
Thursday
Friday
Person to Notify in Case of Emergency
Name*
Relationship*
How is this person connected to you
Address
Emergency Contact's Address if different to yours
Phone*
E Mail Address
example@example.com

BOARD MEMBER

Expression of Interest
If you are interested in becomeing a Board member, it is recommended you read the flyers on Joining ICSA and Becoming a Board Member to familiarise yourself with the requirements of joinng a board.
Previous Experience*

Other Board MembershipsQualificationsExperience with GovernanceProfessional Expertise
Why do you want to be a board member?*
Please provide a brief overview

Expression of Interest