The personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, Chapter 25, as amended and is used solely for the purposes related to the appointment of citizens at large to Council Committees. If you are appointed to a Council Committee, your name may be viewed by the public. If you have any questions about the use of this information, please contact the Clerk's Office at 200 Broadway Street, 2nd Floor, Tillsonburg, ON N4G 5A7, by phone at (519) 688-3009 ext. 3221 or by email at clerks@tillsonburg.ca.