Multicultural Reference Group Membership Application Form

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Please complete details and answer all questions in the form below. The information you provide will assist us in ensuring a diverse range of participants are represented in this group.  
 
Submitting an expression of interest does not guarantee membership. All applicants must reside within the City of Cockburn. 

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Multicultural Reference Group Membership Application Form

All fields are required except where indicated
 
Note: street number and street name are needed for all addresses
Will you be available to attend monthly meetings? (optional)?:
What is your preferred time to meet? (optional):


Do you require childcare? (optional):

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Contact

Address

City of Cockburn
Whadjuk Boodjar
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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Cockburn Nyungar moort Beeliar boodja-k kaadadjiny. Koora, yeyi, benang baalap nidja boodja-k kaaradjiny.
Ngalak kaditj boodjar kep wer kaadidjiny kalyakool yoodaniny, wer koora wer yeyi ngalak Birdiya koota-djinanginy.

The City of Cockburn acknowledges the Nyungar people of Beeliar Boodjar. Long ago, now and in the future they care for Country.
We acknowledge a continuing connection to Land, Waters and Culture and pay our respects to Elders, past and present.