2020 Application

Thank you for your interest in participating in the Regional Chair’s Community Roundtable. Feel free to review the Terms of Reference – it will likely answer any questions you might have about the meetings.

The application form will take approximately five minutes to complete. 


Tell us about yourself

Your responses will help ensure a diverse group of residents attend the meetings. Contact information collected will only be used to communicate with you about the Community Roundtable meetings.

Maximum characters 255
Maximum characters 255
Maximum characters 255
Where do you live in Waterloo Region? required
What is your gender? required
Maximum characters 255
What is your age? required
Options are limited to

Thank you

Thank you for taking the time to express your interest in participating on the Regional Chair’s Community Roundtable. You will receive a follow-up email from staff in the Regional Chair’s Office. The email will come from: snatolochny@regionofwaterloo.ca.

Please hold on while your response is being submitted