Application for Appointment to: Toronto Seniors' Forum (TSF1)

*Important Printed Application Information*

We are not accepting supplementary materials (e.g., resumes, CVs, letters) with applications. Please use Part 7 of the application to discuss your qualifications. If required, you may attach a separate document with your answers to Part 7. When answering questions, you must stay within the character limits where indicated.

Please send your completed form by email to appoint@toronto.ca or by mail to Public Appointments Secretariat, City Clerk's Office, City Hall, 12th Floor, West Tower, 100 Queen Street West, Toronto, Ontario, M5H 2N2.


The City Clerk's Office collects personal information on this form under the City of Toronto Act, S.O. 2006, Chapter 11, Schedule A s. 136 (c), the City of Toronto Municipal Code Chapter 169, Article II and By-law 1076-2006. The information is used to determine eligibility to serve on the City's boards and to enable City Officials to contact members regarding service on boards and agencies. Questions about collection of this information can be directed to the Manager, Public Appointments, City Clerk's Office, 12th floor, West Tower, Toronto City Hall, 100 Queen Street West, Toronto, ON M5H 2N2 or by telephone at 416-397-0088. More information is also available in the Public Appointments Privacy Statement.

Part 1 - Contact Information

Salutation:
First Name:   Last Name:  
E-Mail Address:
Please enter at least one phone number.

Home Address

Street # Street
Unit/Appt # City Province
Postal Code Country

Mailing Address (if different from Home Address)

Street # Street
Unit/Appt # City Province
Postal Code Country P.O.Box

Part 2 - Eligibility

* 1. Are you a resident of the City of Toronto?
* 2. Are you 60 years of age or older?
* 3. Are you an employee of the City of Toronto or one of its agencies or corporations?
* 4. Are you a spouse, partner, child or parent of a Member of Toronto City Council?

Part 3 - Accomodations

1. 1. What accommodation, if any, do you require to participate in the work of the Toronto Seniors' Forum?

Part 4 - Board Membership

* 1. Are you currently serving on a board of a City of Toronto agency or corporation, or as a City of Toronto appointee to an outside board?
* 1a. If yes, please specify which board:
(Please limit your response to 500 characters)

Part 5 - Conflicts of Interest

Members of the public who serve on boards of the City's agencies and corporations must ensure that their personal interests do not interfere with their public duties as a board member.

Personal interests may include the potential for personal, professional, or financial gain for the board member or someone they are associated with such as a family member, employer, or business partner.

As an applicant for appointment, you are required to disclose any personal interests that may conflict with the interests of the agency or corporation to which you are applying. Disclosure of an interest does not disqualify you from consideration for appointment unless the City believes the conflict will prevent you from objectively carrying out the duties of office.

If appointed, you will also be subject to the provisions of the Municipal Conflict of Interest Act. Among other things, that Act requires that if a matter in which you have an interest comes before the board, you must declare your interest openly and refrain from taking part in, or influencing in any way, the debate on the matter.

If you are selected for an interview or are recommended for appointment, we will ask you to complete and sign a more detailed disclosure statement with additional information about your relationship with the City and its agencies.
* 1. Do you have any personal interests that may conflict with the interests of the agency or corporation to which you are applying?
* 1a. If yes, please describe in detail:
(Please limit your response to 1000 characters)

Part 6 - Time Commitment and Availability

1. The Toronto Seniors' Forum meets once a month and the time commitment expected of members is at least 12 hours per month. Additionally, each TSF Member must participate in at least one issue based work group and be willing to provide administrative support when needed. Can you commit to the time required?

Part 7 - Qualifications

1. Why are you interested in serving on the Toronto Seniors' Forum and what relevant skills would you bring?
(Please limit your response to 2500 characters and use point form when possible.)
2. Please tell us about your educational background (e.g. schooling, courses, degrees, diplomas, or certificates) and lived experience, or any other training gained through professional and personal development that is relevant to the forum.
(Please limit your response to 2500 characters and use point form when possible.)
3. Please describe any current or past work, volunteer or board experiences and skills that are relevant to this forum, including positions held and your responsibilities and accomplishments.
(Please limit your response to 2500 characters and use point form when possible.)
4. Please outline your comfort level and experience working with computers, the internet, email, and other technology.
(Please limit your response to 2500 characters and use point form when possible.)
5. Are you fluent in any languages other than English?
5a. If yes, please specify which languages and your comfort level speaking, reading and/or writing in that language.

Part 8 - General

* 1. Biography
Please provide a short biography (500 character limit) containing general information about your education, work experience, community involvement, skills, etc. Your biography will be made public if you are recommended for a board appointment. Please note that biographies may be edited for length and clarity.
(Please limit your response to 500 characters)
* 2. By selecting "I agree," you declare that the information in this application form is true and understand that:
- You may be asked to provide photo identification, references, or other information to confirm your identity, eligibility, and qualifications;
- Your name and biography will be publicly reported if you are recommended for appointment (i.e., your name and biography will be listed on the City's website).
3. To help inform our outreach activities, please tell us how you heard about this opportunity:
3a. If other, please describe:
(Please limit your response to 200 characters)

Part 9 - Confidential Voluntary Diversity Information (Optional)

City Council recognizes that the City of Toronto is best served by boards which generally reflect the diversity of our community.

You are encouraged to complete this confidential diversity questionnaire. The information gathered is used by the City's Civic Appointments Committee and Nominating Panels for the purpose of enabling the City to achieve its objectives for access, equity and diversity. The information provided will not be released for any other purpose without your permission.

The City Clerk's Office will report on the self-identified diversity data in summary form, but will keep the identities of specific candidates confidential. This is done to assess how well City Council's diversity objectives have been met, and decide what improvements can be made, such as targeted outreach or removing barriers to participation.

The City Clerk's Office collects this information in compliance with provisions of the Municipal Freedom of Information and Protection of Privacy Act , the Ontario Human Rights Code, and City Council’s Public Appointments Policy confirmed under By-law 1076-2006.
1. Gender
1a. If other, please specify:
(Please limit your response to 200 characters)
2. Age
3. Aboriginal Peoples
A person is an Aboriginal if he or she is a member of the First Nations, Inuit or Métis peoples of Canada.

Based on this description, do you consider yourself to be an Aboriginal person?
4. Ethnicity/Race
Ethnic/racial groups are defined by race or colour only, not by country of birth, citizenship or religious affiliation.

Please identify which of the following best describes your ethnicity or race:
5. Disability
A person with a disability has an ongoing physical, mental, sensory or learning impairment which may result in experiencing disadvantage or barriers to full participation in society.

Based on this description, do you consider yourself to be a person with a disability?
6. Sexual Orientation
LGBTTIQQ2S is an abbreviation used to represent a broad array of identities such as, but not limited to, lesbian, gay, bisexual, transsexual, transgender, intersex, queer, questioning, and two-spirited.

Based on this description, do you consider yourself LGBTTIQQ2S?
7. Additional Diversity Information
You are welcome to provide any additional diversity information not captured by the questions above (e.g., ethno-cultural, faith, linguistic).
(Please limit your response to 400 characters)

City of Toronto Public Appointments - www.toronto.ca/ServeYourCity