Join the Board of Directors

First Name *

Last Name *

Employer/School

Occupation

Phone Number *

Email Address *

Languages Spoken

Provide a brief biography of yourself, including why you are interested in joining the Middlesex-London Food Policy Council. If selected for the Council this biography may be used on the website to provide information to the community about the MLFPC. *

Please summarize a current food related issue and provide your recommendations or solutions. *

Name of Reference #1 *

Email Address of Reference #1 *

Phone Number for Reference #1 *

Relationship to Reference #1 *

Name of Reference #2

Email Address of Reference #2

Phone Number for Reference #2

Relationship to Reference #2

Declaration *

I understand that Food Policy Council members will be appointed for a term of two years with the possibility of renewal for one term.
I understand that the Food Policy Council will meet up to 10 times per year and that I will do my best to attend these meetings. There will also be opportunities to participate in events or other meetings with stakeholders that I will consider attending.
I give my permission to be contacted by the Recruitment Committee if more information is needed with regards to my application.
I give my permission for the provided references to be contacted with regards to my MLFPC application.
I understand that the biography provided in this application may be used for promotional materials of the Food Policy Council if I am selected to become a council member.

Please upload a copy of your resume as a PDF attachment through email when submitting this form. *

Drop your file here or click here to upload

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