Board Member Application Form

Application for Board Member Variance

Board Member Application Form
Name
Name
First
Last
Address
Address
City
Province
Postal Code
Are you applying as a representative of a Community Association?
Are you currently serving on a City Committee/Commission/Board?
Have you previously volunteered on a City of Port Coquitlam Committee/Commission/Board?
I am attaching my resume
Maximum upload size: 134.22MB
This application will be made available to the City of Port Coquitlam Council & Staff for the sole purpose of making appointments to the Committee/Commission/Board.

Personal information entered on this form is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA) and will be used to contact you if needed. If you have any questions or concerns about how your information will be used, contact the City’s Records and FOIPPA Administrator at 604.927.5250 or corporateoffice@portcoquitlam.ca.

Contact

Carolyn Deakin
Secretary to the Board of Variance
Tel 604.927.5212
Email corporateoffice@portcoquitlam.ca