Step 1 of 3

Personal Information

Personal Details

Title *

First Name *

Last Name *

Linkedin Profile *

Copy and paste your linkedin PUBLIC PROFILE link. Eg. http://ca.linkedin.com/pub/XXXXXXXX/1b/30/213

Preferred Mailing Address

Address *

Address line 2

City *

Postal Code *

Use the following format: M1M 1M1

Province *

Current Employer

Name of Current Employer *

Telephone Numbers

Phone (day) *

Use the following format: (555) 555-5555 x.12345

Phone (evening)

Use the following format: (555) 555-5555

Phone (cell)

Use the following format: (555) 555-5555

Phone (work)

Use the following format: (555) 555-5555 x.12345

Municipality of Residence

Municipality of residence *

Residency in a Municipality or Region is an eligibility criteria for some boards.

Your DiverseCtiy onBoard Account:

The email address and password you enter here will be used to generate your DiverseCity onBoard account. This will allow you to manage your profile, browse and apply to board positions.

Email Address *

A valid email address that you check often

Password *

At least 6 characters long. Must contain at least one non-letter character. The following symbols are allowed !, @, &, *.

Confirm Password *

Mailing Lists

Subscribe to Maytree email communications including the Maytree Newsletter

Subscribe to DiverseCity onBoard e-lerts

Residency Status

Status

Please choose one.*

Immigrant Visible minority Aboriginal

The program invites applicants who identify as immigrants, visible minorities and Aboriginals.

Languages Spoken

You must have fluent written and spoken English in order to join the roster.

If Other, specify

Accessibility Requirements

Braille
Wheelchair Access

If other, specify

Demographic Information

The information requested in this section is collected for internal and statistical purposes only. Statistics Canada ethnicity classifications are used to allow for comparison with the demographics of the GTA. Any public reporting of demographic information will be in the aggregate.

Gender - Birth Year

Gender

Male Female

Year of Birth

Ethnicity

Black East Asian Latin American South-East Asian South Asian West Asian White/Caucasian Other Do not wish to disclose

Black (e.g. origins include Canadian, American, Caribbean, African, Latin American)
East Asian (e.g. origins include Canadian, Japanese, Korean, Chinese)
West Asian (e.g. origins include Canadian, North African, Middle Eastern)
Latin American (e.g. origins include Canadian, Mexican, South American, American)
South-East Asian (e.g. origins include Canadian, Vietnamese, Filipino, Malaysian, Indonesian, Thai, Cambodian)
South Asian (e.g. origins include Canadian, East Indian, Pakistani)

If other, specify