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CAAC Entry Form

Climate Action Art Competition

Climate Action Art Competition Entry Fees

Thank you for entering the competition. We’ll be in touch about where to drop-off your artwork or how to upload your photo or group of photos.

A$5.00

Please contact Dr Bibiana Chan via email or give her a call on 012-613-073 if you have any questions regarding this competition. Registration is complete after payment has been received.

First Name(required)

Surname(required)

Email(required)

Phone

Postcode (required)

Where did you hear about this competition?(required)

Please choose one of the following categories for your entry(required)

Mixed-media (at least 1 piece of plastic 'waste' and 1 piece of organic materials) Photography

Are you in the North Sydney electoral division? (required)

Yes No

Your age group? (required)

10 – 13 14 – 17 18 – 25

Are you of Aboriginal and/or Torres Strait Islander descent? (required)

Yes No Prefer not to disclose

Do you speak a language other than English at home? (required)

Yes No Prefer not to disclose

What is are your ethnic identity/identities? (required)

Indigenous Australian Asian East Asian Hispanic/Latino African European Eastern European Pacific Islander Other Prefer not to disclose

What is your gender identity? (required)

Female Male Non-binary Other Prefer not to disclose

From a scale of 1-10 ('1' being 'it is important to me' and '10' being 'it is very important to me'), how important is climate change/action to you? (required)

1 2 3 4 5 6 7 8 9 10

From a scale of 1-10 ('1' being 'It does not affect me at all' and '10' being 'It affects me greatly'), how much does politicians' actions and stance on climate change affect your voting decision/perception of them? (required)

1 2 3 4 5 6 7 8 9 10

Within Australia/New South Wales, where do you think climate action is urgently needed?(required)

What are some feasible actions to take within Australia/NSW??(required)

If you are in the North Sydney Electorate, please answer the following questions:

Within North Sydney, where do you think climate action is urgently needed?(required)

What would you like the North Sydney MP Hon. Kylea Tink to do for climate action within North Sydney?(required)

From a scale of 1-10 ('1' being 'I don't trust Hon. Kylea Tink' and '10' being 'I totally trust Hon. Kylea Tink'), how much do you trust the current North Sydney MP Hon. Kylea Tink to take effective climate action?(required)

1 2 3 4 5 6 7 8 9 10

What would you like Hon. Kylea Tink to do for climate action within North Sydney?(required)

Is there anything else you would like to tell us (Community Flower Studio) or Hon. Kylea Tink?(required)

Δ

Email: communityflowerstudio@yahoo.com

Ph: +61 4 1261 3073.

Address: 10 – 12 Clanwilliam St, Willoughby, 2068, NSW. Australia.

Thank you for your interest in CAAC!

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