Preliminary Consultation – Your feedback 1Introduction2Your details3Your submission4Privacy Statement You can use this form to: Submit your feedback on a Preliminary Consultation. Before you begin: It takes about 10 minutes to complete this form and you will need to: Tell us your name, address and email address. Include electronic copies of supporting information, if required. Read and accept the Privacy Statement at the end of this form. Read City of Boroondara's general Privacy Statement. After you complete this form we will: Send you an email confirming we have received your feedback. Contact you about your feedback, if required. Send you invites to Council and Urban Planning Special Committee Meetings where this project will be discussed. What happens with your information? We can make your feedback publicly available. We can pass your feedback onto third parties as required (for example: Planning consultants, the Department of Environment, Land, Water and Planning). We may record your information on our customer databases and make it available to relevant Council staff in line with our privacy policy. You are making a submission for the following preliminary consultation: Name * Required First name Last name Email * Required Enter email Confirm email Phone number Address * Required Street address or PO Box Address line 2 Suburb / City State Post code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands I would like to submit feedback about: * Required the study/strategy in general a property within the project study area my own property (same as ‘Address’ supplied previously) a property I own (you own the affected property but don’t live there) Address of property within study area * RequiredAddress of property I own * RequiredDo you support the recommendations of the study/strategy? * Required Yes Partially No Please outline your reasons for supporting, partially supporting or opposing the study/strategy.Would you like to see changes to the study/strategy? * Required Yes No Please detail which changes you are proposing * RequiredPlease upload any additional information to support your submissionYou can upload a maximum of 5 files at 4MB each. Allowed file types: jpg, jpeg, png, doc, docx, pdf Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 5. Maximum file size - 4 mega bytes. Privacy Statement - Preliminary Feedback * RequiredCouncil will collect the information in your submission to progress the project. The information you provide (including personal information) will be used by Council for that primary purpose or directly related purposes, such as contacting you about the project. Council may also use the personal information provided to contact you about other similar projects. Personal information may also be used to update Council’s customer databases to assist Council in discharging its functions or providing services under relevant legislation including the Local Government Act 1989. Council may also publish submissions on its website, provide copies of submissions, and make publicly available lists of submissions during this period. Submissions may be disclosed in a report to Council which will by virtue of the Local Government Act 1989, be available to the public for an extended period. Requests for access to and/or amendment of the personal information should be made to Council’s Privacy Officer (9278 4444). I agree to the Preliminary Feedback Privacy Statement and understand how my information will be used. PhoneThis field is for validation purposes and should be left unchanged.