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Citizen Appointments to Boards and Committees Application Form

For additional information regarding appointments to boards and committees, including Terms of Reference, please visit www.clarington.net/committees.

All applicants must be residents of the Municipality of Clarington.

Are you a Clarington resident?

Yes

Name

Please enter your preferred pronouns or suffix (e.g. Mr. Mrs. Ms etc.)

Address

Town/Hamlet

Postal Code

Phone number

Alternate Number

Email Address

Which formats are you able to attend meetings?

In-person

Virtually

Hybrid (includes in-person and virtual options)

Please specify.

Previous Experience

Are you a current member of any Clarington boards or committees?

Yes

Do you have any previous experience on boards, committees, or task forces? Please include the name of each board, committee or task force you've served on and the number of years served.

Briefly describe your interest in serving on the committee and what you hope to contribute.

Briefly describe your knowledge, professional and employment background, or your lived experience, and how this may support the work of the committee.

Provide a brief profile with examples of work experience, community involvement and other interests that support your application.

Upload your resume

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Consent Statement

By checking this box, I am providing my word that I have read, and accept, the Terms of Reference for this Board or Committee. Should this application form not be fully completed, the Municipality reserves the right to reject the application. In addition, the provision of any false or misleading information on this application form will be sufficient reason for the Municipality to reject the application or to terminate an appointment.

Personal information collected on this form will be used to determine suitability for appointments to Boards and Committees and is gathered under the authority of the Municipal Act. Please direct questions about this collection of information to the Municipal Clerk, 40 Temperance Street, Bowmanville, ON L1C 3A6 or 905-623-3379 ext. 2102.

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Citizen Appointments to Boards and Committees Application Form

Previous Experience