LIST OF SKILLS, ATTRIBUTES & OR QUALIFICATIONS YOU FEEL WOULD BENEFIT THE ADVISORY

The form may be completed by the applicant seeking appointment, or by an individual or organization that wishes to nominate an individual. In all cases, however, the person whose name is being put forward as an applicant MUST sign the form in order to signify that he/she is willing to accept the appointment should it be made. APPLICANT INFORMATION All applications will be considered in confidence NAME OF APPLICANT: REPRESENTING ORGANIZATION: (if applicable