EXPRESSION OF INTEREST FORM
JOIN OUR EXPERT ADVISORY GROUP
Contact Details
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Participation and Commitment
Purpose: Gauge availability and meeting preferences.
Are you comfortable attending regular monthly meetings?
Yes
No
Maybe
If you answered "Maybe", please explain
Preferred meeting format:
In Person - 1/77 Barolin St Bundaberg South 4670
Online
No Preference
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Your Experience
Purpose: Understand the applicant's lived experience with disability and their motivation.
Tell us about your lived experience with disability:
This may include personal experience or your role as a carer or advocate.
Why do you want to join the Expert Advisory Group?
What makes this opportunity meaningful to you?
Relevant Skills or Experience
Purpose: Understand how the applicant might contribute to the program's goals.
Do you have experience with any of the following? (Tick all that apply)
Co-designing programs or services
Reviewing documents or materials for accessibility
Participating in advisory or working groups
Evaluating services or projects
Providing peer support
Advocacy work
Disability Care
Other (please specify):
If you answered Other, please specify:
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Inclusivity and Access
Purpose: Promote diversity and identify any support needs.
Do you identify with any of the following? (Tick all that apply):
I live in a rural area of Queensland
I live in a regional or remote area of Queensland
I have a physical disability
I have a sensory disability
I have an intellectual disability
I have a psychosocial disability
Other
If you answered other, please explain:
Do you need any supports or adjustments to participate?
Yes
No
If you answered yes, please specify:
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Confirmation
Acknowledgement
I confirm the information provided is true and accurate to the best of my knowledge.
Signature
Submit
Submit
Should be Empty: