Hall of Fame Panel EOI & Paticipation Sub Committee EOI

Committee/Panel EOI Form
Motorcycling NSW Limited (MNSW) is collecting your personal information (PI) to facilitate your application and administer your membership benefits. MNSW may use and disclose your PI as set out in this statement and our Privacy Policy (View MNSW Privacy Policy). If you do not provide your PI, we will not be able to administer your member benefits. We may disclose your PI to other parties, including our service providers, partners and sponsors (that may be located overseas from time to time). We may use and disclose your PI to administer your membership, provide you with publications, news, promotions and offers, to contact you to help us improve our products and services, when engaging professional advisers including accountants, auditors and lawyers, and dealing with MNSW's insurer, unless you opt out (see our Privacy Policy for details on opting out). Our Privacy Policy contains information about how you may access and seek correction of your PI, how to complain about a breach of your privacy, and how we will deal with that complaint.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Post Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

I hereby nominate for a position on the below Committee/Panel*

Hall of Fame Selection PanelPaticipation Sub Committee

Please provide a brief outline of your experience in the sport and what you would bring to the committee/panel*
Are you an active Official?*

YesNo
I am a financial member of the following club(s):*
Please declare any conflict of interests:*
e.g. role on a club committee, private promoter services etc
Name*

First NameLast Name
Hereby nominate for the abovementioned position/s and I am prepared to carry out any duties attached to that position if appointed.
Signature*

Clear
Should be Empty:

Committee/Panel EOI Form