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CRADLE COAST NRM COMMITTEE SELECTION PANEL APPLICATION FORM – JANUARY 2011 1.

PERSONAL DETAILS Name: Postal Address: Residential Address: Phone: Mobile Phone: Fax: Email: Date of Birth:

2.

AREA OF INTEREST Please indicate which of the seven categories you represent. If you have multiple interest areas, please number those interests with number 1 being your primary interest area (see below for an interpretation of the categories) State Government Local Government Public Land Managers Community Interests Conservation Interests Aboriginal Industries As guidance to the seven areas of interest the following interpretations are given: Interest Area State Government Local Government Public Land Managers

Community Interests

Conservation Interests

Aboriginal Industries

Interpretation Employees of State Government agencies. Employees or elected members of Local Government. Employees of agencies responsible for managing large areas of land or natural resources including the Parks & Wildlife Service, Forestry Tasmania, Hydro Tasmania as examples. Members of groups with an active interest and engagement in environmental management such as Landcare, Coastcare, Bushcare, heritage and recreational groups. Members of groups with an active interest and engagement in environmental conservation issues. This could also include some forms of “care” groups. Members of the Aboriginal community. Those engaged in activities with sustainable production or environmental issues such as agriculture, energy, fisheries, forestry, processing/manufacturing, tourism.

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3.

OCCUPATION/CAREER BACKGROUND Current employment position (if working) Position: Employer: Previous Positions (or if not currently working) Position: Employer: Position: Employer

4.

QUALIFICATIONS AND RELEVANT SKILLS AND EXPERIENCE Please briefly indicate your skills and experience relevant to natural resource management and/or personnel selection.

5.

EXPERIENCE AND/OR KNOWLEDGE OF REGIONAL NATURAL RESOURCE MANAGEMENT ARRANGEMENTS AND THE CRADLE COAST NRM COMMITTEE

6.

COMMUNITY ASSOCIATIONS AND MEMBERSHIPS Please indicate your links to any relevant community associations. This might range from membership of a Landcare or Coastcare group to service with Local Government as an elected member.

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7.

LETTERS OF SUPPORT Please provide at least one letter of support from a suitable organisation or body relevant to your key area of interest outlined in question 2.

8.

CURRICULUM VITAE Please supply your CV in support of your application.

9.

SUBMISSION OF APPLICATIONS Please submit your application using this form with requested attachments to: Executive Officer Cradle Coast NRM Committee PO Box 338 BURNIE TAS 7320 Or via email with all attachments to: admin@cradlecoast.com Applications close 5pm on Thursday January 27, 2011.

If you have any questions relating to this application, please contact Luke Sayer on 6431 6285.

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http://www.cradlecoast.com/documents/NRMSelectionApplicationFormJan2011_000