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Their Futures Matter Aboriginal Consultative Committee Expression of Interest Personal details Name: Organisation/Service Provider/Agency/ Community: Address: Preferred contact number: Mobile: Home/work: Email (work or home): Preferred contact method: Phone (mobile or home): Email: Nominated by (if applicable): Name: Relationship: Position: Phone number: Do you identify as Aboriginal and/or Torres Strait Islander? Yes, Aboriginal Yes, Aboriginal and Torres Strait Islander Yes, Torres Strait Islander Please indicate your knowledge, skills and/or experience (mark all that apply to you) An Aboriginal person means a person who: (a) Is a member of the Aboriginal race of Australia; and (b) Identifies as an Aboriginal person; and (c) Is accepted by the Aboriginal community as an Aboriginal person 1

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Their Futures Matter Aboriginal Consultative Committee

Expression of InterestPersonal details

Name:

Organisation/Service Provider/Agency/ Community:Address:

Preferred contact number: Mobile: Home/work:

Email (work or home):

Preferred contact method: Phone (mobile or home): Email:

Nominated by (if applicable): Name: Relationship:Position: Phone number:

Do you identify as Aboriginal and/or Torres Strait Islander?

Yes, Aboriginal Yes, Aboriginal and Torres Strait IslanderYes, Torres Strait Islander

Please indicate your knowledge, skills and/or experience (mark all that apply to you)Child Protection/ OOHC in NSW Allied health (eg. Psychologist) Lived experience through Academicmultiple areas of the Educationhuman services system JusticeAboriginal Peak Body DisabilityYoung person Foster/ Kin carerStolen Generations Aboriginal Elder/ leader Supporting Aboriginal familiesand communities

An Aboriginal person means a person who: (a) Is a member of the Aboriginal race of Australia; and (b) Identifies as an Aboriginal person; and (c) Is accepted by the Aboriginal community as an Aboriginal person

If you require clarification on the prerequisites outlined above, please contact Terry Jamieson on 02 9377 6051 or email: [email protected]

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Their Futures Matter Aboriginal Consultative Committee

Relevant experience (professional and/or lived) you have that would bring value to the Committee? (200 words or less)……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

Why are you interested in joining the Committee? (200 words of less)……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

TFM ABORIGINAL CONSULTATIVE COMMITTEE – EXPRESSION OF INTEREST FORM

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Their Futures Matter Aboriginal Consultative Committee

Please list any potential or perceived conflict/s of interest (if any):…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

Please list any memberships of/affiliations with organisations and/or groups:

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

Are you willing to travel to Sydney? YES NO

Do you have any mobility requirements? YES NO

If yes, please specify: ___________________________________________________________________________________________________________________________________

TFM ABORIGINAL CONSULTATIVE COMMITTEE – EXPRESSION OF INTEREST FORM

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Their Futures Matter Aboriginal Consultative Committee

Please provide two Aboriginal community referees:Referee 1:

Name:

Contact number:

Relationship:

Referee 2:

Name:

Contact number:

Relationship:

Optional: You may attach a copy of your CV and/or bio

I have attached a CV or bio: YES NO

Applicant declaration: I ____________________________________________ declare that the information provided in this Expression of Interest is complete and correct.Signed: ________________________________________Date: ___________________

Please return your Expression of Interest to:Email: Post:[email protected] Their Futures Matter

Locked Bag 10Strawberry Hills NSW 2012

TFM ABORIGINAL CONSULTATIVE COMMITTEE – EXPRESSION OF INTEREST FORM

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