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 making. 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 Roads Minden Hills Cultural Centre Cemetery Board Irondale Community Centre 1. Name of Advisory Board/Committee: ______________________________________________________________________ (If interested in more than 1, please number the above in preference of priority) 2. Contact Information: Last Name: ______________________ First Name: _________________________ Mailing Address: ______________________________________________________ Telephone No. (Home) _________________Work: _____________________________ Fax: ________________________ Email: ___________________________________ 3. 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 Board/Committee. I have previously been on this committee for _____ years. 4. _____ 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 cmccarroll@mindenhills.ca, 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.