Salt Spring Island - APC(OCP-LUB), APC & BOV Application Form

Extracted text (beginning)

Bowen Denman Hornby Gabriola Galiano Gambier Lasqueti Mayne North Pender Salt Spring Saturna South Pender Thetis 
 
www.islandstrust.bc.ca 
 
Galiano, Mayne, North 
Pender, Saturna, South 
Pender Islands 
 
Victoria Office 
200 - 1627 Fort Street 
Victoria, BC V8R 1H8 
Ph: (250) 405-5151 
southinfo@islandstrust.bc.ca 
Salt Spring Island, Ballenas- 
Winchelsea Islands 
 
Salt Spring Office 
4-121 McPhillips Avenue 
Salt Spring Island, BC V8K 2T6 
Ph: (250) 537-9144 
ssiinfo@islandstrust.bc.ca 
Denman, Gabriola, Gambier, 
Hornby, Lasqueti, Thetis 
 
Northern Office 
700 North Road 
Gabriola Island, BC V0R 1X3 
Ph: (250) 247-2063 
northinfo@islandstrust.bc.ca 
 
Application: Advisory Planning C o m m i s s i o n/Board of Variance 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Please explain your interest in seeking an appointment: 
 
 
 
Name:  
Address: Daytime Phone: 
Postal Code: Evening Phone: 
 
             
        
  
  
 
If applying for the Advisory Planning Commission, please indicate your area of specialization: 
☐ Planning/Development/Public Administration ☐ Environmental Sciences 
☐ Urban Design/Architecture 
 
☐ Other: 
 
Email(Required):
            
        
  
   
                              
                   
  
   
  
Please indicate the Commission you are interested in joining (check all that apply):
☐ Advisory Planning Commission ☐ Board of Variance 
☐ Agricultural Advisory Planning Commission
☐ Project Advisory Planning Commission 
☐ Project Advisory Planning 
Commission - CHAIR

Fort Street, Victoria, BC V8R 1H8, Tel. (250) 405-5151 foi@islandstrust.bc.ca 
 
Please describe relevant background and experience (resumes are encouraged as attachments): 
 
 
Please describe any similar community involvement: 
 
☐  
 
☐
  
 
Signature: 
 
Date: 
  
  
 
Freedom of Information 
The  collection of personal information,  for  the purpose of  processing  this application, is authorized under  the  Local  Government  Act,  Community  Charter  and  section 
2c(c) of  the  Freedom  of Information and Protection and  Privacy  Act. Enquiries  may  be  directed  to a Deputy  Secretary  at  any of  the Islands  Trust  Offices, as noted on 
page 1 of this form. A request for information, under the Freedom of Information and Protection of Privacy Act may be made to: FOI Coordinator, Islands Trust, 200-1c27 
I confirm that I have read the Terms of Reference that apply to the body I have applied to and commit to upholding all required terms, if appointed.(Required)
If appointed to one of these boards, I permit the Islands Trust to publish my first and last name as a member of that appointed body.(Required)
Print Full Name:

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