APPLICATION Mail completed application form and a resume to
for the attention of:
HOUSING PROVIDER Mira Fearnside, Manager Housing Programs
Niagara Regional Housing
BOARD OF 2201 St. David’s Road, PO Box 344
DIRECTORS Thorold, ON L2V 3Z3
Name (Last, First, Initials)
Apartment Number, Street Address, City/Town, Postal Code
Telephone Home Work
Fax Home Work
Email Home Work
Please share your motivation for applying to be a Board Director of a Housing Provider in
Describe your involvement with affordable housing.
Please describe your current and past community involvement. List community organizations
and outline your responsibilities with each one.
Do you have any special interests, job experiences or education which would assist you in
your role as a Board Director of a Housing Provider?
Housing Providers consist of non-profit housing providers and co-operative housing providers.
Please indicate which housing providers you wish to serve on as a board member by checking the
appropriate category below.
Non-Profit Housing Providers
Co-operative Housing Providers
Have you attached a resume?
Niagara Regional Housing Administrative Staff will be involved in review and/or preparation of
documents for consideration during the verification of information, review, recommendation and
appointment process. Please indicate if we can share this information as required for selection
This information will be used for appointing individuals to the Housing Provider Board of Directors
List. Mail the completed application form and a resume to Mira Fearnside, Manager Housing
Programs, 2201 St. David’s Road, P.O. Box 344, Thorold, ON L2V 3Z3