Edmonton Combative Sports Commission Application Form by BW1JQy


									                     EDMONTON COMBATIVE SPORTS COMMISSION
                       Board Member Application Form – 2013-14 Term
How did you learn                 Examiner           Journal               Sun           Other Newspapers             Email
about Board Vacancy?              Radio              Television            Website       Word of Mouth                Other
Home Address:
Postal Code:                                                  Length of Residence in Edmonton:

Contact Information Please indicate the preferred method of contact
(Home Ph)                       (Work Ph)                         (Cell)

Age Group:                         < 18                   18 - 30                    31 - 50               51 – 64                    65 +

Why are you interested in serving as a member?

Please indicate how your background, skills, and perspective will assist this board.

What do you see as key combative sports issues?

What experience do you have in serving on boards with governance responsibilities?

Is there any other information you would like to add for the selection committee’s consideration?

Applicants are required
to submit:                         Completed Application Form                   Resume           3 Letters of Reference*
                                   Applicant Eligibility Certificate
NOTE: *References should be from individuals that can comment on the relevant qualities, skills or knowledge you possess

By checking this box I declare that the information provided in this application is correct and complete to the best of my
knowledge. I understand that false information given or any relevant information withheld will result in the denial of my

          (Name)                                                       (Date)

This personal information is being collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act and
will be used throughout the recruitment process. If appointed to a civic agency, this information will be provided to the agency and kept on file
in the Office of the City Clerk during your term of appointment. It is protected by the privacy provisions of the Act. If you have any questions
about the collection contact Office of the City Clerk, 780-442-4395.

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             Board Member Application Form – 2013-14 Term Page 2

                  Deadline for Applications is: Friday - SEPTEMBER 28, 2012
                     Return to: CITY OF EDMONTON, Office of the City Clerk
            2nd Floor, Churchill Building, 10019 – 103 Avenue, Edmonton, AB T5J 0G9
                FAX: 780-496-8175            E-MAIL: Civic.Agencies@edmonton.ca

- Scroll down and press Control Click on underlined documents to open

        Edmonton Combative Sports Commission (Web Page – Mandate, Board Members &
        Contact Info)

        Edmonton Combative Sports Commission Recruitment Profile (Eligibility
        Requirements, Board Member Qualifications, Time Commitment and other Board Member

        ECSC Applicant Eligibility Certificate

   Community Services Committee of Council serves as the Selection Committee for this Board.
   It is anticipated that selection processes will take place on one of the following dates:
               o   October 22, 23, or 24, 2012 – Applicant short listing
                       (Only short listed applicants are contacted at this time)
               o   November 5, 6, or 7, 2012 – Applicant Interviews
               o   November 14, 2012 – Appointment made by City Council
                       (Notification by email to all applicants)
   In support of the City’s paperless strategy, correspondence with applicants will be by email.
   Short listed applicants will be asked to complete a   Citizen-At-Large Bio form, and brief
   biography will be made public by being included in the report to City Council, if appointed to
   this Board.

   Appointments to the Edmonton Combative Sports Commission are for a 2-Year term.
   City of Edmonton Volunteer Management practices include an annual evaluation of
   Board Members. (City Policy C476C)

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