Council Membership Form • The Creative Nova Scotia Leadership Council serves as an advisory body to the Nova Scotia

government on matters of cultural policy and cultural sector development. The volunteer council, in partnership with government, advises and makes recommendations to the Minister of Communities, Culture and Heritage on matters pertaining to Nova Scotia’s creative sector. In this capacity, Council is committed to enhancing cultural activity in the Province through strategic research and consultation leading to informed recommendations on investment, promotion and preservation. A major focus of Council’s current work is to support the implementation of the Culture Action Plan, a long-term provincial strategy for culture.

• We strive to be a diverse group of leaders that is representative of the Province’s breadth of ethnic, cultural and regional diversity and welcome applicants from all cultural interests.

• Please complete this application form in full and return it to: Creative Nova Scotia Leadership

Council, Attention: Selection Committee, PO Box 456, Halifax, NS B3J 2R5 Fax: 902-424-0710 and E-Mail: CreativeNovaScotia@novascotia.ca applications also accepted.

• Please attach a covering letter and bio or CV indicating your interest in the Creative Nova Scotia Leadership Council.

Personal Information Surname Given Name(s) Initials Preferred Name

Home phone Cell phone Work phone Fax

Mailing address

Permanent Home Address (if different from mailing address)

City Province Postal code

City Province Postal code

Primary language spoken

Engl i sh French Other

Nova Scotia is my primary place of residency

Yes No

E-mail address:

Website:

Sector Information Please list any current positions or involvement in the Culture sector:

Organization Pos i tion Start Date

Please list any past positions or involvement in the Culture sector: Organization Pos i tion Start Date End Date

Additional Information (Voluntary) Gender:

Female Male

If you would you like to identify as a member of a specific cultural/ethnic community please indicate below:

Please list any specific skills you have that you feel would benefit the council (e.g. Marketing, strategic planning): Max. 50 words

How did you hear about us?

Webs i te

Current member

Mai l ing l i s t

Other