Application: City of Kingston Committee/Board/Commission
APPLICATION
Do you meet the qualifications above for your chosen Commitee/Board?
YES NO
I am applying to serve on the following committee/board:
Your Name:
Your Street Address:
Postal Code:
Home Phone:
Business Phone:
Cell Phone:
E-mail address:
Are you currently serving as a City of Kingston appointee to a City agency, board or committee?
YES NO
If 'Yes' above, which one?
... and length of service?
Years
Are you an employee of the City of Kingston or its agencies, boards or commissions?
YES NO
YOUR BACKGROUND/RESUME
Please tell the Nominations Advisory Committee and City Council about yourself and why you are interested in serving on this committee. Include relative information such as expertise, education and/or real-life experience as it relates to the committee or board that you have chosen.
SKILL SETS
Please list skills sets that you would bring to this committee that would be an asset:
NOTICE OF COLLECTION: Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of the Municipal Act, 2001, and in accordance with MFIPPA. Personal information collected on the application form will be used to assist in selecting appointees for the various civic bodies and may form part of the publicly available meeting agendas and minutes. If appointed to a civic body, your personal information may also be used by City staff to conduct committee and City business. Questions regarding the collection, use, and disclosure of this personal information may be directed to the Kevin Arjoon, Deputy City Clerk, 613-546-4291 ext. 1262 or karjoon@cityofkingston.ca.