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Expression of Interest

Appointment to Accessibility and Inclusivity Adivsory Committee

Name

Street Number

City/Town

Postal Code

Telephone Number

Email Address

Preferred method of contact

Telephone

Regular Mail

Please provide a brief note explaining why you are interested in serving on the Accessibility and Inclusivity Advisory Committee and what contribution you believe you could make.

Why you are interested in serving on the committee

What Contributions you believe you can make to the committee

Please note that Committee meetings are held during "regular business hours" (between 8:30 a.m. and 4:30 p.m. Monday to Friday).

Notice of Collection of Personal Information: Personal information on this form is collected under the legal authority of the Municipal Act, as amended. This information is collected and maintained for the purposes of applying to join an advisory committee of Council. Questions about the collection and storage of this information should be directed to the Clerk, 4305 Hamilton Rd, Dorchester ON, 519-268-7334 or via email: clerk@thamescentre.on.ca