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Committee Application Form

Please click here for a printable version.


Committee Application Form

Name of Committee/Board: 

Applicant's Name: 

Permanent Address:

Email: 

Phone #: 

 

Are you a qualified elector in the Town of Kirkland Lake?    Yes     No

To be a qualified elector in the Town of Kirkland Lake you must be a Canadian citizen, at least 18 years of age, residing in the Town of Kirkland Lake or is the owner, tenant, spouse or tenant of land, and are not prohibited by law from voting in the Town of Kirkland Lake elections.

Why are you interested in this position?

What qualification or skills do you possess that would be an asset for this committee/board?



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