Members Advisory Group Application

Please submit this application by Sunday 13 September 2026.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Name*

First Last

Address*

Street Address Address Line 2 Town/City State Postcode Country

Phone*

Email*

Barossa Co-op Membership Number*

Occupation / Experience (100 words)*

Why do you want to be part of Barossa Co-op’s Members Advisory Group? (200 words)*

What do you hope to achieve by being part of the group? (200 words)*

What local insights/experience do you think you can bring to the group? (200 words)*

Have you read the terms of reference?*

Yes

Are you willing to meet 3 to 4 times per year on a voluntary basis?*

Yes

Please upload resume or other supporting documentation.

Drop files here or

Max. file size: 1 MB.