• Naming Opportunities Submission

  • Select the town you wish to propose a name for?*
  • Is the proposed name a commemorative name?*
  • Do you have consent to use this name?*
  • Which of the naming themes does this proposal best fit under? Select all that apply.*
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  • Your Details

  • Which of the following best describes your connection to the South Gippsland Shire?*
  • What is your gender?*
  • What is your age group?*
  • Are you Aboriginal or Torres Strait Islander?*
  • To help us better target our communications, please let us know how you heard about the consultation. Select all that apply.*

  • Contact Information

    In case we need further details on your submission, please put your preferred contact number and email address below.

  • Format: (000) 000-0000.
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