Independent Planning Commission - Speaker Registration Form

I would like to speak at the Public Event as:

The Applicant (or a representative)

A representative of the Department of Planning and Environment or another NSW Government Agency

A representative of the Local Council, local councillor, State or Federal Member of Parliament

An owner or a tenant of a neighboring property to the proposed development

Any person whose consent is required for the application to proceed

A local resident who will be particularly affected by the proposed development

If so, please set out the way in which you are particularly affected *

A2. I am not directly affected by the proposed development but have an indirect interest:

I would like to speak at the Public Event because:

I have a family member or close friend who is directly impacted by the proposed development

I am a local resident in the same suburb or town

I have a general interest in the topic, issue and/or application

I have expertise and/or experience in a relevant field

I represent a peak industry body with an interest in the proposed development application

I represent a public interest group which has concerns about the proposed development application

OTHER

Please set out the relevant field *

Other - Please specify *

B. PLEASE NOMINATE HOW LONG YOU WOULD LIKE TO SPEAK FOR:

B1. How long do you wish to speak for? *

(Please note to allow as many people as possible to speak, requests over five minutes may not be able to be granted)

B2. I would like to participate in the public event via:
Video conference (using my own computer and internet service) Telephone call (the commission will call my phone)

B3. Are there any times on the day of the event you are not available to speak?
Morning Middle of the day Afternoon

B4. If you wish to speak on behalf of an organisation, body or group please provide following information:
Yes, I am No, I’m not

Name Of Organisation *

(Please note the Commission reserves the right to verify with the organisation body or group)

Street Address

Suburb

State *

Postcode *

Email *

Phone *

C. ADDITIONAL MATERIAL

C. I have additional material that I wish to present to the Panel when I speak at the public event. I provide the following link to a shared drive where the Commission can download this material prior to the event (Google Drive, Dropbox etc)

D. PRESENTING TO THE PANEL

In the interests of openness and transparency, I acknowledge that my presentation to the Commission Panel will be recorded for transcription purposes and that it may also be livestreamed by the Commission. Should the Commission decide to live stream proceedings, I understand that my presentation to the Panel may be recorded and/or re-broadcast by third parties, including media organisations.

Yes No

By using the speaker registration form I accept that I have read, understood and agree to the following terms and conditions:

Any information given to us may be published on our website, unless explicitly stated otherwise. All personal contact details (other than names) will be removed before online publication, but may be provided to relevant government departments. Before submitting the form, please read our Privacy Statement at www.ipcn.nsw.gov.au or call us on (02) 9383 2100.

Speaker Registration Form