Application for the Stratford Public Library Board

Name:

Address (including postal code):

Telephone:

E-mail:

Minimum Requirements:

Check the following that apply to you:

A Canadian Citizen

18 years of age or older

A resident of Stratford or an eligible elector in Stratford

I have reviewed the day and time for Library Board meetings and I am able to attend in person

What is your understanding of the mandate or responsibilities of the Stratford Public Library Board?

What interests you most about the Library Board?

How does your previous experience serving on committees or boards in the community enhance the work of the Library Board?

What do you hope to achieve by being on the Library Board?

I acknowledge, that if appointed as a member of the Library Board, I am governed by all applicable legislation, By-laws and policies for the conduct of meetings and activities, including but not limited to:

Public Libraries Act, Municipal Act, and Municipal Conflict of Interest Act
Code of Conduct
Accessibility for Ontarians with Disabilities Act and Regulations

By submitting this application for consideration, you are declaring that the information in your application is true.

The City of Stratford is committed to workplace diversity and inclusion, and this commitment extends to our Committee appointments. An inclusive workplace creates a more supportive environment and ultimately helps us to provide better service to our diverse community.

Aboriginal/Indigenous Peoples are those who identify as members of First Nations (status, non-status, treaty, or non-treaty), Inuit or Metis communities in Canada. Based on this description, do you consider yourself to be an Aboriginal/Indigenous person?

Yes

No

Prefer not to answer

Member of a visible minority means anyone other than aboriginal/indigenous peoples who are non-Caucasian in race or non-white in colour. We recognize that this language is outdated and that the term racialized is becoming more common. The Ontario Human Rights Commission explains that because race has its roots in social, not biological, characteristics and includes much more than skin colour, their preferred term is racialized group or person. We are using the term visible minority, not racialized group, because it is the term used by Statistics Canada in its census data.

Based on this description, do you consider yourself to be a member of a visible minority?

Yes

No

Prefer not to answer

The term disability covers a broad range and degree of conditions, some visible and some invisible. A disability may have been present at birth, caused by an accident, or developed over time. These include physical disabilities, hearing or vision disabilities, developmental disabilities, learning disabilities, chronic illness and mental health disabilities and addictions. A disability may be permanent, temporary, or episodic which may result in experiencing disadvantage or barriers to full participation in society.

Based on this description, do you consider yourself to be a person with a disability?

Yes

No

Prefer not to answer

Municipal Council approves all appointments. The appointment process is governed by Council’s policy on Advisory Committees. For more information, please contact the City Clerk's Office at 519-271-0250 ext. 5237.

How did you hear about this opportunity?

City website

Social media (e.g. Facebook)

Friend or co-worker

Printed newspaper advertisement

Other - specify

Personal information collected in this application is gathered in accordance with the Municipal Act, 2001, for use when making appointments to Boards and Advisory Committees for the City of Stratford. The information on this application will be provided to City Council for selection of members to serve on City Boards and Committees and may be subject to disclosure under the Municipal Freedom of Information and Protection of Privacy Act. Questions about this collection should be directed to the City Clerk, P.O. Box 818, Stratford, ON N5A 6W1, or by telephone at 519-271-0250, extension 5237, during regular business hours.

Signature of Applicant:

Clear

Date: