Online Form - Expression of Interest – Community Group/Club Details

Community Group/Club Name

Key Contact Name

Mobile Contact

Email Address

Please provide us with information about your community group or club (i.e. goals/vision, membership base, volunteer capacity etc.)

Tell us in 100 words or less why your community group or club should be considered for the Socially Inclusive Communities WA (SICWA) program.

What does inclusion mean to your community group or club?

Will your club or group be willing to share stories for the benefit of SICWA and Town of Port Hedland?

YesNo