Online Boards and Committees Application Form

By submitting this application form you are applying to volunteer on one of the City of Burlington's boards or citizen committees. To view a board or committees mandate/mission click here.

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Name of Individual:

Address:

City:

Postal Code:

Home Telephone:

Enter a valid phone number. Example: 123-456-7890

Business Telephone:

Enter a valid phone number. Example: 123-456-7890

Email Address:

Enter a valid email address. Example: name@company.com

Fax Number:

Enter a valid phone number. Example: 123-456-7890

How do you prefer to be contacted?

Occupation:

Please mark below the specific Board or Committee you wish to volunteer for (maximum of 2). If applying for more than one Board or Committee, please note your order of preference.

Burlington Museums Board Enter a valid ranking. Example: 1, 2 or 3

Burlington Accessibility Advisory Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Inclusivity Advisory Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Mundialization Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Seniors Advisory Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Sustainable Development Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Civic Recognition Committee Enter a valid ranking. Example: 1, 2 or 3

Burlington Doors Open Organizing Committee Enter a valid ranking. Example: 1, 2 or 3

You may express interest in a board or committee not currently accepting applications. Applications are kept on file for one year.

Briefly describe your volunteer experience within the past five years:

Briefly describe additional skills or experience relevant to each board or committee you are applying for. Attach additional sheets if required.

Would you like to attach additional sheets? (pdf, max. 5MB)

I hereby consent/do not consent to the release of my name to the public and my contact information to committee members and staff.

Consent

Do not consent

Personal information on this form is collected under the authority of the Municipal Act, S.O. 2001, c.25 and will be used to evaluate applications for appointees to local and regional Boards & Committees. The disclosure of this information is governed by the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.M.56. Inquiries may be directed to the City Clerk:

426 Brant Street, P.O. Box 5013,
Burlington, ON
L7R 3Z6

Fax: 905-335-7881
Email: cityclerks@burlington.ca
Phone: 905-335-7600, ext. 7698

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