Board Candidate Form

PERSONAL PROFILE

NAME:____________________________________________________________= _____

(First Name)(Middle Name or Initial)(Last Name)

ADDRESS:_________________________________________________________= _____

POSTAL CODE:_________________________TELEPHONE #(S):____________________

OCCUPATION:______________________________________________________= _____

Do you live in the Birchmount Bluffs Neighbourhood Centre catchment area?̶= 1;

(Lake Ontario to Eglinton, Victoria Park to McCowan)

History of volunteer work, employment or other interests: (Please list dates and responsibilities). This experience need not be in Canada.

_________________________________________________________________= _____

_________________________________________________________________= _____

_________________________________________________________________= _____

_________________________________________________________________= _____

What areas of the Birchmount Bluffs Neighbourhood Centre Board work are of parti= cular interest to you?

_________________________________________________________________= _____

_________________________________________________________________= _____

How will being a Birchmount Bluffs Neighbourhood Centre Board member be good for you personally?

_________________________________________________________________= _____

_________________________________________________________________= _____

What area(s) of expertise do you bring with you that could be of value to the Birchmount Bluffs Neighbourhood Centre Board of Directors:

_________________________________________________________________= _____

_________________________________________________________________= _____

_________________________________________________________________= _____

_________________________________________________________________= _____

From our experience, Board Directors spend a minimum of 4 hours per month on Boa= rd and Committee work. Depending on your level of involvement and commitment, = this time might increase. Do you see this as a problem?

Please supply two references: At least one should be from someone with whom you ha= ve

worked in an employment capacity or as part of a group.

1. Name:_______________________= _____________________________________

=

Address:____________________= ______________________________________

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Telephone #(s):____________________________________________________

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2. Name:_______________________= _____________________________________

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Address:____________________= ______________________________________

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Telephone #(s):____________________________________________________

BOARD

Please allow my name to stand for nomination to the Birchmount Bluffs Neighbourhood Centre Board of Directors.

__________________________ Signatur= e

__________________________ Date

OR

VOLUNTEER

I prefer to consider a volunteer role other than Board work. Refer my name to= the volunteer coordinator.

___________________________ Signature

___________________________ Date