City of London - City of London - Application for Appointment to City of London Community Advisory Committees

Note: Fields marked with ★ are mandatory.

Notice of Collection of Personal Information

Notice of Collection of Personal Information – personal information collected on this application is collected under the authority of the Municipal Act, 2001 and will be used by Members of Council and City of London staff in their consideration of appointment to Community Advisory Committees, Boards and Commissions. Questions about this collection should be addressed to Manager, Records and Information Services, 3rd floor, City Hall, 300 Dufferin Ave., London, ON N6A 4L9. Tel: 519-661-2489 ext. 5590.

Please note that supplementary materials (such as resumes, CVs, or referral letters) will not be accepted as part of this application. Attachments to this form are also not permitted. To ensure your experience and qualifications are fully considered, please provide detailed responses directly on the application form addressing each question in detail. We are committed to ensuring a fully accessible recruitment process. If you require any accommodation, please contact us at accessibility@london.ca.

Application Details

Committee you are interested in serving on:

If applying for the Accessibility Community Advisory Committee, please indicate if you are a person with a disability.

Are you applying as a Youth Representative (ages 15 to 24)?

Contact Information

Name

Phone Number

Address

City

Province

Postal Code

E-mail Address

Experience and Qualifications

Have you previously served on a City of London Community Advisory Committee? If yes, please provide details, including committee name, dates served, and key contributions.

What skills, knowledge, or experience do you bring to this committee?

What do you hope to contribute to the Community Advisory Committee?

Please share any additional experience, training, or community involvement that would support your role on this committee.

Diversity, Equity, and Inclusion

The City values the contributions of individuals from diverse backgrounds. How will your work, community, or lived experiences enhance the committee’s efforts to serve Londoners inclusively?

Confirmations

I declare the following:

I am not a City employee or current Council member.

I further declare:

I understand that the commitment may be up to 6 hours per month to attend meetings and prepare.

And finally, I declare:

I understand that my application may be included on a public agenda that is published on the City website and my name may be indexed by search engines such as Google.

Outreach Information

How did you hear about this opportunity? (Optional)

If you selected 'Other', please specify

The personal information on this form is collected under the authority of the Municipal Act, 2001 and will be used to assist the Municipal Council in selecting appointees for various City of London Boards, Commissions and Committees. Questions about this collection may be referred to the Manager, Records and Information Services, 3rd floor, City Hall, 300 Dufferin Avenue, London, ON N6A 4L9; Tel: 519-661-2489 ext. 5590.

Note: If the form does not appear to submit, please open each section and confirm that there are no issues or missing required fields.