Appendix J: Application Form for Heritage Advisory Commission

Declaration and Consent of Applicant

By submitting this form, I solemnly declare that I am eligible to be appointed to the Commission or Advisory Committee(s) indicated above, as I am not an elected official, officer or employee of The Regional District of Kitimat-Stikine.

I solemnly declare the following direct and/or indirect pecuniary interest* arising from a business relationship with the Regional District of Kitimat-Stikine.

(*A direct pecuniary interest is a financial gain or loss that accrues to the applicant. An indirect pecuniary interest is a financial gain or loss that accrues to the applicant’s family or household.)

I am willing to accept an appointment by the Board of the Regional District of Kitimat-Stikine to the Heritage Advisory Commission as specified by this application. The information from the applications is collected for administrative and/or operational functions of the Regional District of Kitimat-Stikine as authorized by the Local Government Act. This information has been collected, and will be used and maintained, in accordance with the Freedom of Information and Protection of Privacy Act.

Thank you for completing this application form and for your interest in volunteering with us.