Required fields are marked with asterisks (*)

Town of Ajax Recreation & Culture
Older Adult Task Force Application Form

Be an ambassador and assist with the Town's Age-Friendly Ajax Community Plan recommendations. The goal of the Task Force is to strengthen and increase recreation and cultural opportunities for residents that are ages 55 and up. Submit an application to be considered for a volunteer committee member position.

In order to submit an application, you must be an Ajax resident willing to participate in scheduled meetings and be committed to attending a minimum of eight meetings per term (term is two years), as well as undertake special projects which may be initiated in accordance with the task force mandate. Please provide us with the information indicated below and email any pertinent documentation that may assist in the review of your application to 55plus@ajax.ca. Interested applicants may be required to take part in an interview.

Do you participate in recreation programs/events?
 
Age and Residency
 

Collection of Personal Information

Personal information collected on this form is collected under the Municipal Act, S.O.2001, c.25, and will  be used for the purpose of program registration, payment, aggregate statistical reporting and allocation of staff resources. Questions of this collection should be address to the Town of Ajax Records and Freedom of Information Coordinator at 65 Harwood Avenue South, Ajax, Ontario, L1S 2H9.

Learn more about the Town of Ajax’s Privacy policy

 https://www.ajax.ca/en/inside-townhall/privacy-policy.aspx

Accessibility

If you require this form in an alternative format, please contact the Town of Ajax Accessibility Coordinator, at 905-683-4550, or by e-mail at contactus@ajax.ca.