Diversity and Inclusion Action Team Application

Applicant's Name

First

Last

Mailing Address

Address Line 1

Address Line 2

City

Province

Postal Code

Phone

Email

Applicants are encouraged to note if they self identify with any of the following diverse groups:

Other (Please specify)

Please explain the reasons why being a member of the Inverness County Diversity and Inclusion Action Team is of interest to you?

Have you participated in any diversity and inclusion training in the past five years?

Please explain

Are you currently a member of a group or organization that works on diversity and inclusion issues?

Please explain

Describe what you hope can be achieved in the next three years of the Action Team working with the municipality.

Agreement

I confirm that this application is true to the best of my knowledge and is being submitted in accordance with the application criteria and no information has been withheld.

Agreement

I acknowledge that the information I am submitting on this form will be treated in confidence only by relevant municipal employees