2026 Customer Assessment Panel - Expression of Interest

Thanks for getting to this point! There's just one more step, simply fill out the form below to register your interest and we'll be in touch. Expressions of interest close 19 June 2026.

About you

Your name(Required)
What is your age group?(Required)
What is your gender?(Required)
Home ownership status(Required)
Customer type(Required)
Select all that apply
Connection type(Required)
What area to do you live in?(Required)

Property address (within our service area)(Required)

Motivation for your application

Availability and preferred engagement method

What days of the week are you generally available for meetings or discussions?(Required)
Select all that apply
What times of the day are you generally available for meetings or discussions?(Required)
Select all that apply
The Panel will meet twice for two hours. Can you commit to participate in BOTH of these Customer Assessment Panel meetings?(Required)

Preferred engagement method

What is your preferred method of communication for receiving general updates and information from Westernport Water?(Required)
Select all that apply
How would you prefer to participate in assessment panel meetings?(Required)
Select all that apply
Your email address(Required)
Best time to call you to discuss your application
Select all that apply

Conflict of interest

I will disclose any relevant interests and take reasonable steps to avoid real and perceived conflicts of interest by disclosing any potential conflicts of interest that may compromise my objectivity or the integrity of the panel?(Required)
This field is for validation purposes and should be left unchanged.

Westernport Water uses this form to collect information, including personal information, from members of the public. The Corporation will use this personal information only for the purpose for which it is collected [or for an associated secondary purpose]. For further information please refer to Westernport Water’s Privacy Policy.