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Committee Member Application Form

This form is used for all Boards and Committees of Council. Vacancies to Boards and Commitees will be posted in Employment Opportunities.

You can print this form at anytime by right clicking and selecting print. A copy will automatically be emailed to you once you submit.

Name:

Street Number:

Street Name:

P.O. Box

Town/City:

Province

Postal Code

Phone Number:

Email Address:

Committee Preference: Please outline the Committee(s) you would like to sit on.

Resume or expression of interest: (Please attach resume or expression of interest which outlines why you should be appointed to the committee and the skills you will bring)

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Do you have Volunteer Experience?

Yes

Accomodation: We want to ensure persons with disabilities are able to participate on municipal committees. If you have a disability, what accomodations, if any, would you need to carry out this position?

Additional Information: Please provide any additional information which may be of assistance in the selection process.

Applicants Signature:

Clear

We thank all applicants for their interest, however only those selected to serve will be contacted. ________________________________________________________________________________________________________________________

I agree to the following terms

Your personal information is collected under the authority of sections 11(1) and 227 (c) of the Municipal Act, 2001. The personal infortmation will be used by the Municipality of Grey Highlands Staff for responding to your service request. Questions regarding this collection should be addressed to: Municipal Clerk, 1-206 Toronto St. S., Markdale, ON N0C 1H0, 519-986-2811 or clerks@greyhighlands.ca

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Committee Member Application Form

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