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* 1. Confidential to the FCM Chief Elections Officer & Elections Committee;

I, the undersigned, do hereby consent to have my name submitted for consideration as a member of the Board of Directors of the Federation of Canadian Municipalities.

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* 2. I am an elected municipal official holding office with an FCM Municipal Member in good standing.

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* 3. I am attaching a copy of a resolution from my municipal council, or Provincial or Territorial Municipal Association (for PTA representatives), authorizing me to stand for election as a representative on FCM's Board of Directors.

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* 4. Upload your resolution.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 5. I confirm that my municipal council, or supporting Association, is prepared to incur any cost related to my attending meetings of FCM's Board of Directors.

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* 6. I will be a registered voting delegate at the FCM Annual Conference, to be held in Toronto, ON, May 25-28, 2023.

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* 7. I have read and agree to abide by the FCM Code of Ethical Conduct, Harassment Policy, and Anti-Racism and Equity Commitment Statement.

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* 8. NAME

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* 9. TITLE (e.g. Councillor, Mayor, Reeve)

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* 10. E-MAIL

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* 11. FCM MUNICIPAL MEMBER

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* 12. PROVINCE/TERRITORY

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* 13. PHONE NUMBER

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* 14. Signature
By checking this box you provide consent for your nomination to be brought forward.

Note: The deadline to be included on the ballot for a Director position is May 14, 2023. Candidates may announce their candidacy from the floor of the nomination meeting, however they must submit a completed consent form and an official resolution prior to the nomination meeting.

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