Thank you for your interest in becoming a member of the Community Health Advisory Network. As the seats at this table are limited, we ask that you please fill out the form to help us learn more about you and your interest in joining the Community Health Advisory Network. This opportunity is open to adults (18+) who currently live in Mississauga.

We encourage people with disabilities to apply. Please let us know if any accommodations are needed for the application process.

If you would like to learn more information about the Community Health Advisory Network, please visit www.moht.ca. If you have any questions, please contact info@moht.ca

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* 1. Do you currently live in Mississauga?
*Please note that we are looking for members who currently live in the Mississauga area

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* 2. Are you over the age of 18?
*Please note that we are currently looking for members who are age 18 or over.

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* 3. Are you able to commit 1hr -1.5hrs a month?
*Please note that we are currently looking for members who are able to commit to this time commitment.

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