Board of Directors – Candidate Form - Keystone Centre

Candidate Form

The Keystone Centre will be accepting applications until October 10, 2025 for three (3) at-large members for our Board of Directors. Strong leaders and engaged community members are critical to the success of the Keystone Centre and are encouraged to complete the candidate form below.

Candidate Form - Board of Directors

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Name(Required)

Home Address(Required)

Street Address City Province Postal Code

Business Address

Street Address City Province Postal Code

Home Phone(Required)

Business Phone

Email(Required)

Occupation

Reason for Interest in Board Position(Required)

Community Involvement i.e., organizations/associations:

Current(Required)

Past(Required)

General Information

Please provide any information regarding yourself that you feel would be pertinent to the role of director. i.e., hobbies/family