EOI to Become a QWaLC Board Member

NOTE: This form needs to be completed and submitted online no later than 5pm Friday 30th September 2022

"*" indicates required fields

DD slash MM slash YYYY
I declare that I reside in the QWaLC Region selected above and*
My EOI is Seconded by:
(is a current member of the QWaLC Member Group listed above and they reside in the selected QWaLC Region)
DD slash MM slash YYYY
I declare that I have received permission from the person listed above and*
Criteria: Please provide a brief summary of your relevant knowledge, experience, skills and networks and how they can contribute to QWaLC and it's Member Groups in the chosen Region:

Having read the information regarding the role and understanding the requirements*