Online Form - Update Volunteer Bushfire Brigade Details

Bushfire Brigade Register

Please complete the below form to ensure the Shire has your correct contact details on the Bushfire Brigade Registers.

If you wish to no longer be on the Brigade list please check the box that you wish to be removed.

Brigade Name *

I wish to be removed from the Bushfire Brigade Register

Yes

Full Name *

Date of Birth *

Contact Number *

Email Address *

Street Address:

City:

State:

Post Code:

Country:

Postal Address

Suburb

State:

Post Code:

Country:

Next of Kin

Next of Kin Contact Number

Relationship