BioBlitz2017 Team BioBlitz2017 Organising Team EOI Please complete the expression of interest form below if you would like to be involved as part of the Organising Team at Tarkine BioBlitz 2017. 1 Welcome2 Your details3 Emergency/Allergies/Dietary info4 Role5 Dates6 Meals and Accommodation7 And youre done! As a member of the BioBlitz2017 Organising Team for Tarkine BioBlitz 2017, you will be assigned a specific role essential to the event's running and supported to fulfill it successfully. You need not be an expert in anything specifically, just have a willingness to give your time and apply your skills to make the event happen. In return for your contribution, we offer to contribute to your return transport, and cover your meals and accommodation costs for the duration of BioBlitz2017. If you are interested to be on the Organising Team, please complete the Expression of Interest (EOI) form below and event managers will contact you shortly to discuss specifics and find the right role for you. Alternatively, if you do not wish to help organise, but would still like to attend Tarkine BioBlitz 2017: Go to http://sales.bobbrown.com.au/bioblitz2017 to register as a participant. Join us for another great BioBlitz in takayna / Tarkine! The Bob Brown Foundation would like to invite you to participate in the third Tarkine BioBlitz (23 - 26 November 2017) Tarkine BioBlitz 2017 is the third BioBlitz to be held in takayna/Tarkine and will be held over 72 hours. You are welcome to join us from Thursday 23 to Sunday 26 Nov or any time in between. On Friday 24 Nov we will also be inviting local school groups to join the BioBlitz. Our base camp for the duration of the event will be at the Riverbend Youth Centre, approximately 6km south of Smithton, North-west Tas. Accommodation options include motorhome sites, tent camping, dormitories and some more private facilities. Each day we will travel out to explore and discover Tarkine coast, forest and plains locations and regrouping at the base camp each evening to share food, discoveries and stories. We hope you are as inspired by takayna/Tarkine as we are and look forward to having you involved in Tarkine BioBlitz 2017. Name* First Last Gender*FemaleMalePrefer Not to AnswerDate of Birth* Contact Phone Number*Contact Email Address* Address*Where are you based? Where will you be travelling to BioBlitz from? Street Address Address Line 2 City State Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Emergency Contact Name*Please enter the name and contact details of the person we could contact for you in case of emergency. First Last Relationship to you*Emergency Contact Phone Number*Emergency Contact Email AllergiesPlease describe any allergies you have and what medication (if any) you carry for these allergies.Gluten-free meals*Please indicate if you would prefer to have gluten-free meals at BioBlitz.Yes please (Gluten-free for me)No thanks (I'm happy to eat gluten)Dietary requirementsAll meals are vegan*, but If you have special dietary requirements please detail them here. *NOTE - Food was THE most highly rated aspect of previous BioBlitzes (average = 95%!!) Roles*Indicate any particular roles you feel you may be able to assist on or skills you have to offer. Logistics/Transport Equipment coordinator Volunteer coordinator Kitchen/food coordinator First Aid coordinator IT coordinator Promotion/Media coordinator Biosecurity/Hygiene coordinator Data/Monitoring and Evaluation coordinator Photography/Video coordinator Other (please specify) SkillsList any particular skills you have that you would be happy to contribute at BioBlitz2017. What dates would you like to attend?*BioBlitz2017 runs 23-26 November inclusive. Thursday 23rd Nov Friday 24th Nov Saturday 25th Nov Sunday 26th Nov Thursday 23rd November 2017Thursday MealsWhich meals would you like on Thursday 23rd November? Lunch Dinner Thursday AccommodationWhich accommodation would you like on Thursday 23rd November? - Dorm rooms contain single beds and sleep 6-10 people. - Motor home sites have power and access to the campground amenities. - Tent sites are unpowered and have access to the campground amenities. Dorm Room (Thursday) Motor Home Site (Thursday) Tent Site (Thursday) Friday 24th November 2017Friday MealsWhich meals would you like on Friday 24th November? Breakfast Lunch Dinner Friday AccommodationWhich accommodation would you like on Friday 24th November? - Dorm rooms contain single beds and sleep 6-10 people. - Motor home sites have power and access to the campground amenities. - Tent sites are unpowered and have access to the campground amenities. Dorm Room (Friday) Motor Home Site (Friday) Tent Site (Friday) Saturday 25th November 2017Saturday MealsWhich meals would you like on Saturday 25th November? Breakfast Lunch Dinner Saturday AccommodationWhich accommodation would you like on Saturday 25th November? - Dorm rooms contain single beds and sleep 6-10 people. - Motor home sites have power and access to the campground amenities. - Tent sites are unpowered and have access to the campground amenities. Dorm Room (Saturday) Motor Home Site (Saturday) Tent Site (Saturday) Sunday 26th November 2017Sunday MealsWhich meals would you like on Sunday 26th November? Breakfast Lunch Congratulations you're done! Thanks for taking the time and offering to contribute to making Tarkine BioBlitz2017 amazing!! Just check the "I'm not a robot" box below and hit "Submit" and we'll be in touch to make arrangements shortly. Please confirm you are not a robotPhoneThis field is for validation purposes and should be left unchanged.