Please fill out the fields below
Title *Please select one optionDrMissMrMrsMsProfMx
First Name *
Surname *
Street Address *
Suburb *
StateVICNSWNTQLDSATASWA
Postcode *
Email *
Phone Number *
Current Employer
Current Job Title
Which panel are you registering for?Creative Learning PartnershipsCreative Infrastructure Support ProgramCreators FundUnlocking Capacity - VIPIMusic WorksTouring VictoriaBuilding Audiences FundCreative ActivationCreative Workers FundAny panel
Please outline why you would like to serve on Creative Victoria's Advisory Panel *
Resume *
Please indicate program and year if you have served on a Creative Victoria Panel.
Please indicate program and year if you have served on a federal or local government advisory panel.
Are you identified as any of the following
Please indicate the areas in which you have specific experience and expertise. (Select a maximum of five) *
