Online Form - Expression of Interest – Volunteer Bush Fire Brigade

Name*

Company*

Shire of Coolgardie Location

Mailing Address

Mailing Address:

City:

State:

Post Code:

Country:

Email*

Contact Number*

Please give details below of your skills & experience in Bushfire Control management*

Please give details below of your skills & experience in Operating equipment or machinery*

Please give details below of your skills & experience in any other areas relavent*

Restrictions - Please identify if there any restrictions or work commitments that would prevent you from undertaking the role*

Volunteer Consent*

Yes - By checking this box you consent to online submission