Nominate - Community Services, Department of Communities, Child Safety and Disability Services (Queensland Government)

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Department of Communities, Child Safety and Disability Services

Nominate

This form is to be completed by all carers and representatives of organisations that support carers who wish to be considered for membership of the Queensland Carers Advisory Council.

An asterisk (This field is required) indicates a required field.

Privacy statement

The Department of Communities, Child Safety and Disability Services is collecting your personal information for the purpose of assessing your application to be a member of the Queensland Carers Advisory Council. Your application will be provided to a panel that will consist of Queensland Government staff who will assess your suitability for appointment.

If you are a recommended candidate, your personal information will be provided to the Minister and Premier for approval. If you are a successful candidate your personal information may be disclosed to the Queensland Police Service for the purpose of conducting a criminal history check. If successful, your name may be published in a media release (with your consent) and your personal information may be used for the administration of the Council and its activities. Your personal information will be handled in accordance with the Information Privacy Act 2009.

Are you eligible?
Are you a Queensland resident?This field is required
Not Eligible

Sorry, you are not eligible. You must be a Queensland resident to be a member of the Council

Membership
Which of the following roles would you like to nominate for?This field is required
Your personal details
Salutation:
Further details
Address or PO Box
1st referee details

Please provide the contact details of referees who have a thorough knowledge of your role as a carer or carer representative, you involvement in the community and/or who are able to provide a character reference. Please advise any nominated referees that we may contact them.

2nd referee details
Employer agreement to participate
If your participation on the Council would be during your usual working hours, you will need to have permission from your employer’s Chief Executive Officer, Chairperson of the board or similar:
Relevant experience
About you
Government bodies
Descriptions
Do any of the following descriptions apply to you? (tick as many as apply):
Declaration
I declare that:This field is required
Is your feedback

Please submit your comments on the department's Compliments and Complaints section.

Please submit your comments on the Queensland Government website Contacts form.