Boards & Committees Volunteer Application Form

Required fields are marked with an asterisk (*)

Personal information
Are you a current member of a Board or Committee?
Boards & Committees Being Applied for
You may select up to 3 committees: *
Design Advisory Committee
Please indicate the position(s) you are applying to represent:

* Notwithstanding the Public Appointment Policy, current members of the Design Review Committee may also serve as a member of the Design Advisory Committee.
Regional Watersheds Advisory Board
Please indicate the position(s) you are applying to represent:
Western Common Advisory Committee
Please indicate the position(s) you are applying to represent:
Women's Advisory Committee
Please indicate all categories you can represent:

One file only.
2 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

Diversity and inclusion are key values of the municipality. Regional Council recognizes that the municipality is best served by boards, committees and commissions whose membership reflects the diverse communities they serve.
You are encouraged to complete this voluntary and confidential diversity questionnaire. The information will be used to assess how well the municipality is doing in meeting its objectives relating to diversity and inclusion.
The information you provide will be held in strict confidentiality and will not be used or released for any other purpose without your permission.  The Municipal Clerk’s Office collects this information in compliance with the requirements of Part XX of the Municipal Government Act respecting freedom of information and the protection of privacy, the Personal Information International Disclosure Protection Act, as well as HRM’s Public Appointment Policy and Community and Race Relations Policy.
If other, please specify
Aboriginal Peoples
Aboriginal peoples of Canada are defined in the Constitution Act, 1982, Section 35 (2) as including the Indian, Inuit and Métis peoples of Canada. Based on this description, do you identify yourself as Aboriginal?
A person with Disability
A person with a disability is a person who has or has had any degree of physical disability, mental impairment, developmental disability, learning disability, mental disorder or workplace injury.  Based on this description, do you consider yourself to be a person with a disability?
A person in a visible minority group
According to the Employment Equity Act, members of a visible minority are people in Canada (other than Aboriginal peoples) who are non-white in colour or non-Caucasian in race, regardless of their place of birth or citizenship.

Examples of visible minorities include, but are not limited to:
  • Black
  • Non-white Latin American (including Indigenous people from Central and South America)
  • East Asian (e.g., Chinese, Japanese, Korean)
  • South Asian/East Indian (e.g., Indian, Pakistani, Bangladeshi, or East Indian from Guyana, Trinidad or East Africa)
  • Southeast Asian (e.g., Burmese, Cambodian, Filipino, Laotian, Thai, Vietnamese)
  • Non-white West Asian, North African or Arab (e.g., Iranian, Lebanese, Egyptian, Libyan)
  • People of mixed origin (e.g., with one parent member of a visible minority group).
Are you a member of a visible minority?
You are welcome to provide any additional diversity information not captured by the questions above.
How did you hear about available position(s)?
Check all that apply
Check all that apply
If you have questions regarding this form or the selection process, please contact the Municipal Clerk’s Office at 902.490.4210 or 
In accordance with Section 485 of the Municipal Government Act (MGA), the personal information collected on this form will only be used for purposes relating to the selection process for Boards and Committees.

If you have questions related to the collection and use of this information, please contact the Access and Privacy Office at 902.490.4390 or
Enter the characters shown in the image.