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Application for the Appointment to a Board or Committee

Personal information collected on this form is collected under the authority of the Municipal Act, 2001, as amended, for the purposes of reviewing this application. Questions regarding the collection of personal information should be directed to the Municipality of North Perth, 330 Wallace Avenue North, Listowel ON N4W 1L3, telephone 519-292-2062, Clerks Department. 

Are you a resident, owner or tenant of property in the Municipality of North Perth, or the spouse of a resident, owner or tenant or property in the Municipality of North Perth?
 
Are you a Shareholder, Director or Officer of a Corporation that is physically located in the Municipality of North Perth?
 
Are you 18 Years of Age or Older?
 
Are you currently employed by the Municipality of North Perth?
 
Which Board or Committee are applying to become a member of?
What is your availability to attend board/committee meetings (please select all that apply)
 
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