Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I am (choose all that apply)

Business owner or employee

Local resident or body corp member

Property owner

Community/interest group representative

Local government employee

Other

Declaration *

If selected, I am willing to abide by the Group Charter for the CRL Community Liaison Group. I will: • Commit to attending the majority of CLG meetings • Contribute to discussions on issues relevant to the design and construction of the project • Provide a two-way information flow between the community I represent and other members of the group • Treat other Community Liaison Group members and their views respectfully I understand that all supplied information will remain private and confidential. I declare that the information I have provided is true and correct at the time of writing. I understand that submitting this application does not guarantee or confirm my membership of my City Rail Link Community Liaison Group.

Agree

Disagree