Required fields are marked with asterisks (*)

Application for public member appointment

Planning Advisory Committee

Name

Mailing Address

Municipality

Postal Code

Primary Phone Number

Secondary Phone Number

Email Address

Are you a resident or business owner in Stony Plain?

Yes

The personal information requested on this form is being collected under the authority of Section 4(c) of the Protection of Privacy (POPA) Act and will be used for the purpose of determining eligibility and qualifications for a position with a Town of Stony Plain board or committee. If you have any questions regarding the collection, use or disclosure of personal information, please contact the FOIP Coordinator at 780-963-2151.