Citizen Committee Expression of Interest

Applicant Information

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1. Full name (Required.)

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2. Preferred name

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3. Street address (Required.)

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4. Community or ward (Required.)

Ward 1 - rural

Ward 2 - urban

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5. Telephone (Required.)

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6. Email

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7. Accessibility accommodation requested

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8. Committee Interests
Select every committee for which you wish to be considered. Public-member positions may be filled only when a vacancy or recruitment process is approved. (Required.)

Municipal Communications Committee - 1 public member required

Finance and Audit Committee - up to 2 public members permitted

Governance By-law and Policy Standing Committee - up to 1 voting public member permitted

Community Well-Being Committee - up to 4 public members permitted

Homelessness and Community Impact Committee - up to 6 public members; all appointed members vote

Parks and Community Services Advisory Committee - up to 5 public members permitted

Tourism Advisory Committee - up to 5 public members permitted

Other committee or future opportunity - identify below

Other committee or future opportunity (please specify)

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9. Interest and Contribution
Why are you interested in serving on the committee or committees selected? (Required.)

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10. Interest and Contribution
What relevant experience, knowledge, skills, community connections or lived perspective would you contribute? (Required.)

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11. Interest and Contribution
How would you help the committee serve the interests of the Municipality as a whole? (Required.)

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12. Homelessness Committee Applicants — additional information
Complete this section only if you wish to be considered for the Homelessness and Community Impact Committee. Council will seek a group whose combined knowledge and perspectives reflect the committee Terms of Reference. Select all areas you would contribute; formal credentials are not required.

Lived experience of homelessness or housing insecurity (optional self-identification)

Housing or emergency-shelter experience

Health, mental-health, substance-use or social-service knowledge

Public-safety or emergency-response knowledge

Business or neighbourhood perspective

Rural community knowledge

Urban community knowledge

None of the above

Other relevant knowledge or perspective (please specify)

Providing lived-experience information is voluntary. Please share only what you are comfortable disclosing; do not include names or identifying information about other people. The Municipality will use application information for the appointment process in accordance with applicable privacy and records-management requirements.

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13. Optional:
Briefly explain the perspective, knowledge or experience selected above

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14. Current organization, agency, business or community affiliation, if relevant

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15. Please read (Required.)

I understand that, if appointed, I will serve the Municipality as a whole and will not represent or bind an employer, agency, interest group or population unless Council expressly designates the position.

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16. Availability and participation
I can attend scheduled meetings (Required.)

Yes

It depends on the schedule

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17. Availability and participation
I can participate electronically when authorized (Required.)

Yes

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18. Availability and participation
I can review meeting materials in advance: (Required.)

Yes

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19. Describe any scheduling limitations

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20. Eligibility and Public Service
Residency (Required.)

I am a resident of the Municipal District of St. Stephen.

I am not a resident

If you are not a resident, describe your connection to the Muncipality

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21. Eligibility and Public Service (Required.)

I am willing to participate respectfully and work with people who may hold different views.

I understand that committee service is to advance the interests of the Municipality as a whole.

I understand that members must comply with applicable legislation, municipal policies, the committee Terms of Reference and Council direction.

I understand that committee discussions and records may be public, subject to applicable access-to-information and privacy requirements.

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22. Conflicts of interest
Do you have any actual, potential or perceived conflict of interest related to the mandate of a committee selected above? (Required.)

Yes

If yes, describe the circumstances. Disclosure does not automatically disqualify an applicant.

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23. Declaration and Consent
I certify that the information provided is accurate. I consent to the Municipality using this information to assess my suitability for appointment, contact me about this application, verify information where authorized, and retain the application in accordance with applicable records-management and privacy requirements. I understand that Council makes appointments and that my name may appear in public Council records if I am appointed. (Required.)

By checking this box I agree to the conditions above

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24. Additional Information

I consent to electronic communication about committee opportunities

I wish to be considered for future vacancies for up to 12 months.

Citizen Committee Expression of Interest

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* 1. Full name (Required.)

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* 2. Preferred name

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* 3. Street address (Required.)

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* 4. Community or ward (Required.)

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* 5. Telephone (Required.)

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* 6. Email

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* 7. Accessibility accommodation requested

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* 8. Committee InterestsSelect every committee for which you wish to be considered. Public-member positions may be filled only when a vacancy or recruitment process is approved. (Required.)

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* 9. Interest and ContributionWhy are you interested in serving on the committee or committees selected? (Required.)

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* 10. Interest and ContributionWhat relevant experience, knowledge, skills, community connections or lived perspective would you contribute? (Required.)

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* 11. Interest and ContributionHow would you help the committee serve the interests of the Municipality as a whole? (Required.)

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* 13. Optional: Briefly explain the perspective, knowledge or experience selected above

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* 14. Current organization, agency, business or community affiliation, if relevant

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* 15. Please read (Required.)

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* 16. Availability and participationI can attend scheduled meetings (Required.)

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* 17. Availability and participationI can participate electronically when authorized (Required.)

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* 18. Availability and participationI can review meeting materials in advance: (Required.)

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* 19. Describe any scheduling limitations

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* 20. Eligibility and Public ServiceResidency (Required.)

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* 21. Eligibility and Public Service (Required.)

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* 22. Conflicts of interestDo you have any actual, potential or perceived conflict of interest related to the mandate of a committee selected above? (Required.)

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* 24. Additional Information

1. Full name (Required.)

2. Preferred name

3. Street address (Required.)

4. Community or ward (Required.)

5. Telephone (Required.)

6. Email

7. Accessibility accommodation requested

8. Committee Interests
Select every committee for which you wish to be considered. Public-member positions may be filled only when a vacancy or recruitment process is approved. (Required.)

9. Interest and Contribution
Why are you interested in serving on the committee or committees selected? (Required.)

10. Interest and Contribution
What relevant experience, knowledge, skills, community connections or lived perspective would you contribute? (Required.)

11. Interest and Contribution
How would you help the committee serve the interests of the Municipality as a whole? (Required.)

13. Optional:
Briefly explain the perspective, knowledge or experience selected above

14. Current organization, agency, business or community affiliation, if relevant

15. Please read (Required.)

16. Availability and participation
I can attend scheduled meetings (Required.)

17. Availability and participation
I can participate electronically when authorized (Required.)

18. Availability and participation
I can review meeting materials in advance: (Required.)

19. Describe any scheduling limitations

20. Eligibility and Public Service
Residency (Required.)

21. Eligibility and Public Service (Required.)

22. Conflicts of interest
Do you have any actual, potential or perceived conflict of interest related to the mandate of a committee selected above? (Required.)

24. Additional Information