Form last updated 1 April 2021

Form 12

Use this application form to request the Commissioner for Consumer Protection’s leave to be to be appointed or act as a member of a management committee of an incorporated association if you are otherwise prohibited from doing so under the Associations Incorporation Act 2015 (the Act).

This form must be lodged prior to an appointment being made.

Please note: You are only required to declare offences that occurred in the past five years from either the date of conviction or release (whichever is the latter).