Name

First Last

Title/Role

City

Province/Territory

Phone Number

Personal Twitter

Personal LinkedIn

Organization (if applicable)

I understand that by submitting this Expression of Interest to become a CAN Individual Collaborator, and upon its approval, I am accepting the opportunity to collaborate and engage with the Canadian Accessibility Network and its collective community.(Required)

I understand the above.

I understand that my role on the Advisory Council is to take part in the national conversation during each of the formally scheduled meetings that take place a minimum of three times per year for approximately two hours each. Any obligation to engage outside of these formally scheduled meetings is optional but encouraged.(Required)

I understand the above,

By submitting this application, I agree that I am committed to advancing accessibility for persons with disabilities and acknowledge that I am ready to and/or am actively pursuing equity, diversity and inclusion in my business practices.(Required)

I understand the above.

I understand that this is a non-binding agreement, and I can withdraw as a CAN Individual Collaborator by providing written notification to the CAN National Office at [email protected] at least 30 days in advance of termination to allow for appropriate time to finalize any outstanding collaborations.(Required)

I understand the above.

I understand that CAN is subject to the policies of Carleton University and the laws applicable to universities in Ontario, including the Freedom of Information and Protection of Privacy Act, which may, in some cases, require the University to disclose information shared with CAN by a CAN Individual Collaborator.(Required)

I understand the above.

Applicant's typed signature (please type your full name)

Date

Please submit an updated resume or CV highlighting your experience in accessibility and/or lived experience. Please sent this item by email to our national office at:(Required)

[email protected]

I understand the above

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CAN Collaborator Individual Expression of Interest