Name *

First Name

Last Name

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Street Name and Suburb *

Address 1

Address 2

City

State/Province

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Finding out more about you *

Please tick all that apply:

I am a Resident (owners and/or renter)

I am a Ratepayer (property owner)

I am a Business Owner in COV

Which of the following are you concerned about? *

Council Spending

Increased Rates

Lack of Engagement

Parking Issues

Parks Management

Traffic Management

Underground Power costs

Other? Please add details in the comments box below

We need Volunteers, are you interested in helping? *

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