Domestic, Family and Sexual Violence Advisory Council – Expressions of Interest form

Name, position, contact information

(maximum 750 words).

Please write a statement on your suitability for the Advisory Council. Your response should provide clear examples with reference to the selection criteria.

The applicant declares that they do not have any actual, potential or perceived Conflict of Interest, other than those set out below and how they propose to mitigate them:

If at any time the applicant forms an actual, potential or perceived Conflict of Interest, then the applicant will:

• disclose that conflict of interest to the Department; and
• take action necessary to avoid the conflict as directed by the Department.