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Please complete this advisory committee application form in its entirety. Should this application form not be fully completed, the County of Frontenac reserves the right to reject the application. In addition, the provision of any false or misleading information on this application form will be sufficient reason for the County of Frontenac to reject the application or to terminate an appointment.

Applications for Community Development Advisory Committee, Planning Advisory Committee and Joint Frontenac Accessibility Advisory Committee close January 15, 2019

First Name

Last Name

Street Address

City/Village

Postal Code

Requirements

Are you a Canadian Citizen Are you a Canadian Citizen

Yes

Minimum 18 Years of Age Minimum 18 Years of Age

Yes

Eligible Municipal Elector in the County of Frontenac Eligible Municipal Elector in the County of Frontenac

Yes

I have subject area expertise I have subject area expertise

Yes

Name of Committee to which you are seeking appointment: First Choice Name of Committee to which you are seeking appointment: First Choice

Community Development Advisory Committee

Frontenac Accessibility Advisory Committee

Kingston Frontenac Public Library

Planning Advisory Committee

Name of Committee to which you are seeking appointment: Second Choice Name of Committee to which you are seeking appointment: Second Choice

Community Development Advisory Committee

Frontenac Accessibility Advisory Committee

Kingston Frontenac Public Library

Planning Advisory Committee

Please provide a brief summary of those elements of your education, employment history, experiences and interests which you feel should be considered in support of you application:

Notice of Collection/Your Signature

Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of the Municipal Act, 2001, and in accordance with MFIPPA. Personal information collected on this application form will be used to assist in selecting appointees for the various civic bodies and may form part of the publicly available meeting agendas and minutes. If appointed to a civic body, your personal information may also be used by County staff to conduct committee and County business. Questions regarding the collection, use, and disclosure of this personal information may be directed to Jannette Amini, Manager of Legislative Services/Clerk, 613-548-9400 ext. 302 or jamini@frontenaccounty.ca.

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