Regional District of Kitimat-Stikine

Apply to be a Heritage Advisory Commission Member

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APPLY FOR THE HERITAGE ADVISORY COMMISSION (HAC)

* Required Field

* Name:

* Street or Mailing Address:

* City:

* Province:

* Postal Code:

* Home Phone:

* Alternate Number - Daytime:

* E-mail:

During which hours are you available for meetings?

* Reasons for seeking appointment:(max 250 characters)

* Special background or expertise:(max 250 characters)

* History of community involvement. (past and present):(max 250 characters)

Additional Information:(max 250 characters)

Special Skills or Qualifications

* Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through activities which support your application for appointment to the Heritage Advisory Commission. (max 200 characters)

Previous Volunteer Experience

* Summarize all previous volunteer experience: (max 200 characters)

Declaration and Consent of Applicant

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.

*By checking this box, printing my name and submitting this form, I confirm that the information provided is accurate and complete.

Applicant Name:

Date:

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.

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