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 addressed 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.