volunteer advisory board and committees application form

Thank you for your interest in serving on a Township of Minden Hills Advisory Board/Committee.
We appreciate the involvement of our local citizens in assisting Council with their decision
The Township is looking for volunteers to participate as members on the following Advisory
Board/Committees for the 2015-2018 term of Council:
Planning & Development
Community Service
Lochlin Community Centre
Minden Hills Cultural Centre
Cemetery Board
Irondale Community Centre
Name of Advisory Board/Committee:
(If interested in more than 1, please number the above in preference of priority)
Contact Information:
Last Name:
______________________ First Name: _________________________
Mailing Address:
Telephone No. (Home) _________________Work: _____________________________
Fax: ________________________ Email: ___________________________________
Please attach why you wish to serve on the noted Board/Advisory Committee and why
you consider your background and interest would be appropriate to that
I have previously been on this committee for _____ years.
_____ N/A
An up-to-date resume would be appreciated, if available.
Please forward your completed Application Form and resume to the Clerk’s Department,
Township of Minden Hills, 7 Milne Street, Minden, Ontario, K0M 2K0, or email
[email protected], or phone (705) 286-1260 extension 217 by April 2, 2015.
Please note, if you are chosen to be a member of an Advisory Board/Committee, a Police
Check will be required at no cost.
Personal information contained on this form is collected in compliance with the Municipal Freedom of Information and
Protection of Privacy Act and will be used for the purposes of appointing members to the Township’s Advisory
Boards/Committee(s). Questions about the collection and use of this information should be directed to the Clerk’s
Department, Township of Minden Hills, 7 Milne Street, Minden, Ontario, K0M 2K0 (705) 286-1260 ext. 217.