I would like to apply as a member for the following local government area, in which I live, work or study:
BrimbankHobsons BayWyndhamMeltonother Western suburbs
Why do you want to become a member?
Do you have any formal qualifications, please list. What is your related experience?
Tell us a bit about your background and interests:
Please disclose any potential conflict of interest:
I accept these terms.