Advisory Board Registration Form

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Education:

Which advisory boards are you interested in? (1st Preference)

Which advisory boards are you interested in? (2nd Preference)

Which advisory boards are you interested in? (3rd Preference)

Please indicate your community service involvement/experience?

Indicate your qualifications for the board position of interest (upload additional information if needed):

Are you aware of any conflicts of interest that would prevent you from serving on a City board/committee? If so, please indicate the nature of the conflict below.

0/50

Please upload your resume or CV

If you have a pre-written resume with relevant working / organisational experience or a reference letter, you may upload them here (optional). Max total file size = 2 MB

Signature