Advisory Bodies

Civic Agencies Application Form

Applicant
(Required information marked with *)
Title: Mr. Ms. Dr. Other:
Last Name: *
First Name: *
Initials:
Home Address: *
 
     City: *
     Postal Code: *
Phone - Residence: * - -
Phone - Business: - - Ext:
E-mail:
Occupation:
 

Employer

 (Please leave blank or fill in all employer details.)
Name:
Mailing Address:
 
     City:
     Postal Code:
Phone: - - Ext:
 

Civic Agency
Civic Agency you are applying for (Use separate application for each agency): *
 
Category: *
 
Have you read the agency description and are you able to commit the required time?
  Yes No
 
Which applicant orientation session did you attend?
 
Have you previously been a member of this civic agency?
  Yes No
If "yes", during what years did you serve?
 
Are you applying to serve on another civic agency or agencies during the upcoming term?
  Yes No
If "yes", which other civic agency or agencies have you applied for?
 
 

Nominating organization
Name:
Mailing Address:
 
     City:
     Postal Code:
Officer of Nominating Organization:
     Last Name:
     First Name:
     Phone: - - Ext:
 

Qualifications
What skills will you bring to the agency?
 
What would be your primary goals for this agency?
 
If you are fluent in a second language, please state what language(s):
 
Business/work experience in the past five years:

Note: if self-employed or retired, please indicate your occupation.
 
How is your business/work experience related to the mandate of the civic agency?
 
Educational background / Professional qualifications:
 
How is your background related to the mandate of the civic agency?
 
Community/volunteer activities in the last five years:
 
Other relevant information, if any:
 
                  
 

Your application/résumé will be made available to Vancouver City Council, civic staff, and the applicable civic agency for the sole purpose of making appointments to civic agencies. Your information is collected under the authority of the Freedom of Information and Protection of Privacy Act and any applicable by-laws.
For more information, please e-mail or call Terri Burke at 604.871.6399 or Bonnie Kennett at 604.873.7269.

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