/ Corporate Services, Clerk’s
10 Peel Centre Dr., 5th Floor
Brampton, ON L6T 4B9
905-791-7800 ext. 4330 / Nominations to the Greater Toronto
Airports Authority (GTAA)
Board of Directors
Please Print Clearly
1. General
Applicant’s Last Name / First Name Initial / Home Tel. No. / Bus. Tel. No.
Street/P.O. Box No. / Apt. No. / City/Town / Province / Postal Code
2. Skills and Abilities
Describe specific skills including experience on boards of complex business organizations, financial literacy, or senior private or public-sector leadership and accomplishments. (Attach additional pages and/or resumé if required.)
3. Community Involvement
Name of Agency / Telephone Number / From / To
Yr. / Mo. / Yr. / Mo.
1
Address / Position Held / Contact Name
Name of Agency / Telephone Number / From / To
Yr. / Mo. / Yr. / Mo.
2
Address / Position Held / Contact Name
Name of Agency / Telephone Number / From / To
Yr. / Mo. / Yr. / Mo.
3
Address / Position Held / Contact Name
Name of Agency / Telephone Number / From / To
Yr. / Mo. / Yr. / Mo.
4
Address / Position Held / Contact Name

V-02-049 03/02

4. Other Information
I am a resident, owner or tenant of land in the Region of Peel or spouse of such a person. /  Yes / No
I have demonstrated community involvement in the Region of Peel. /  Yes / No
I have knowledge and skills related to one of the following areas:finance and human resources with regard to executive compensation, executive succession planning, talent management, labour relations and creating a high performance culture. (If Yes, please specify in Section 2.) /  Yes / No
I have prior experience on a Board of Directors. (If Yes, please specify in Section 2.) /  Yes / No
I have availability during normal business hours as well as evening hours, as attendance will be required at board, committee and public meetings. Please indicate the approximate number of hours per month you can devote to GTAA board matters. ______/  Yes / No
I have specific knowledge or experience which may be an asset to the Board. (If Yes, please specify in Section 2.) /  Yes / No
I am an officer or employee of a firm or corporation, including any airline or other service provider, which carries
on business at an airport operated by the GTAA. (If Yes, please specify in Section 2.) /  Yes / No
I am a member, officer or employee of a trade union, professional or business association which represents any firm or corporation, or the employees of any firm or corporation, which carries on business at an airport operated by the GTAA. (If Yes, please specify in Section 2.) /  Yes / No
5. Mandatory Requirements
  • I certify that:

  • I am a Canadian citizen or permanent resident at least 18 years of age;

  • I am not related to another member of the GTAA Corporation;

  • I have not been found by a court to be a mentally incompetent person of unsound mind;

  • I am not an undischarged bankrupt;

  • I have not been convicted of an indictable offence;

  • Currently and within the past two years, I do not and have not held federal, provincial, or municipal elected office, nor am I or have I been a member of the Senate;

  • Currently and within the past two years, I am not or have not been an employee or agent of Her Majesty the Queen in Right of Canada or a province, or an employee or agent of a crown corporation, an officer or employee of a municipality,officer or employee of the GTAA, a shareholder or subsidiary of the GTAA, or filed a return under the Lobbyists Registration Act or registered under a similar provincial or municipal law;

  • I am not a director, officer, or employee of any person who has, or within six monthsimmediately preceding the date of appointment had, a financial or commercial agreementor arrangement with the GTAA, the Government of Canada or the Ontario Government, TheRegional Municipalities of Peel, York, Halton or Durham or the City of Toronto that couldreasonably be perceived to interfere with their ability to discharge their fiduciary duty to acthonestly and in good faith in the best interests of the GTAA.

6. Declaration
I hereby certify the statements made herein are true and I understand that any falsification of facts submitted in this form is cause for discharge from the Region of Peel nomination process to the Greater Toronto Airports Authority (GTAA) Board of Directors.
Signature of Applicant / Date
Yr. / Mo. / Day

Deadline for Submission

Friday,May 18, 2018 - 4:30 p.m.

Please fax completed applications to the attention of the Regional Clerk at 905-791-1693 or personal delivery to 10 Peel Centre Dr., Brampton –5thFloor, Office of the Regional Clerk

Notice With Respect To The Collection of Personal Information
(Municipal Freedom of Information and Protection of Privacy Act)
Information on this form is collected for the administration of the Greater Toronto Airports Authority (GTAA) Operating By-law 14, sections 4.3 and 4.4 (b) to determine suitability for appointment to the GTAA Board of Directors. Questions about this collection of personal information should be forwarded to the Regional Clerk, 10 Peel Centre Dr., Brampton, ON L6T 4B9, 905-791-7800, Ext. 4330