Required fields are marked with asterisks (*)

Welcome

Thank you for your interest in serving on a Council Advisory Committee or Special Purpose Body.

Please submit only one application per person; include a resume, if applicable.

If you require any accommodations or any support at any point during the application process, please contact the Office of the Regional Clerk:


Office of the Regional Clerk
Regional Municipality of Waterloo
2nd Floor, 150 Frederick Street
Kitchener ON N2G 4J3
Phone: 519-575-4493
TTY: 519-575-4608
Email: regionalclerk@regionofwaterloo.ca

The Regional Municipality of Waterloo recognizes the importance of acknowledging the land on which our Advisory Committees and Special Purpose Bodies gather. We will listen, educate ourselves on decolonization, and uplift and celebrate the Indigenous peoples of this land. All Committees will ensure an equitable and a culturally safe environment for participants to come together and exchange knowledge and information in a healthy and constructive way. For more information on cultural safety please let Staff know or visit the Office of Reconciliation and Equity, Diversity, and Inclusion

About this Application
This application is your opportunity to share why you are a strong candidate for this position. Your responses should demonstrate your interest and how your skills and experience, including lived experience, fit with the mandate and qualifications of the committee, board, agency, or commission for which you are applying. Candidates will be selected in accordance with the Recruitment, Selection and Appointments of Citizen Members to Regional Advisory Committees Policy.

Terms of Reference for each Committee or Special Purpose Body can be found here or by contacting the Office of the Regional Clerk. Please send your completed form to regionalclerk@regionofwaterloo.ca, mail or drop off to 150 Frederick St. Kitchener, ON, N2G 4J3, 2nd Floor, Attention: Regional Clerk’s Office.

The Region values the diversity of the Community and encourages the equal opportunity for all eligible individuals to apply in accordance with the Standards for Accessibility Policy. All applicants must be 16 years of age and either a resident or the owner of property within the Region of Waterloo. Region of Waterloo employees are not eligible to apply for committee positions.

If you require assistance in completing this form or would like additional information, please contact the Regional Clerk’s Office at 150 Frederick St. Kitchener, ON, N2G 4J3, 2nd Floor or via email: regionalclerk@regionofwaterloo.ca.

Deadline for applications is 11:59 p.m. on the closing date.

Privacy Statement
Personal information, as defined by Section 2(i) of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA. Personal information on this form will be used to assess applicants’ qualifications for appointment to one of the Region’s various committees or boards. Personal information may form part of meeting agendas and minutes, and therefore may be made available to members of the public at the meetings, through requests, and through the website of the Regional Municipality of Waterloo and/or applicable Board. Questions regarding the collection, use, and disclosure of this personal information may be directed to the Regional Clerk’s Office. The Nominating Panel reserves the right to check references and verify information contained on these forms.


PLEASE NOTE: Applicants may update their answers until this form is complete and submitted. You may navigate away from this application form and return to it later to complete your answers; please ensure that you click the save button at the bottom of the page before leaving this page. Once the form has been complete and submitted, applicants will not be able to update their responses.

Do you have any attachments to include in your application? (resume, cover letter, copies of certifications, etc)
 
Committee members typically meet for approximately 2-4 hours per month. Members have the option to participate in meetings either virtually or in-person. Are you able to attend meetings during business hours and/or evening hours?
 

Confidential Voluntary Diversity Information (Optional)

Regional Council recognizes that the Region of Waterloo is best served by boards, committees, and tribunals which generally reflect the diversity of our community. You are encouraged to complete the below diversity questions. This information is used to help the Region in achieving its objectives for access, equity, diversity, and reconciliation.

Please indicate your age.
 
Are you currently a student (high school, post-secondary, etc)?
 
Do you identify as a member of the 2SLGBTQQIA+ community?
 
Do you identify as any of the following? Choose all that apply.
 
Do you experience any of the following which impacts your daily activities?
 
Please confirm the following: I am a property owner or resident of the Region of Waterloo, being 16 years of age or older, unless otherwise specified in the terms of reference of the advisory committee or special purpose body.
 

Conflicts of Interest
Members of the public who are appointed to represent the Region of Waterloo must ensure that their personal interests do not interfere with their public duties as a committee member. A conflict of interest arises when your personal interests conflict, or are perceived to conflict, with the interests of the Region of Waterloo. You are required to disclose any personal interests that may conflict with the interests of this committee. Disclosure does not disqualify you from consideration for appointment. 

Do you have any personal interests that may conflict with the interests of the position for which you are applying?
 
Please note that successful applicants will be expected to adhere to the Code of Conduct for Citizen Appointments to Local Boards, Foundations and Advisory Committees. If chosen as a successful applicant, do you agree to adhere to this Code of Conduct?
 
By selecting I agree you declare that the information in this application form is true and you understand that you may be asked to provide information to confirm your identity, eligibility, and qualifications.
 
I understand that if I am recommended for appointment, my name will be listed publicly on Region of Waterloo Council agendas and minutes which are posted publicly on regionofwaterloo.ca.
 
Please confirm the following: I am a property owner or resident of the Region of Waterloo, being 16 years of age or older, unless otherwise specified in the terms of reference of the advisory committee or special purpose body.