Apply to be a Local Champion

We need leaders from all sectors across the Greater Toronto and Hamilton Area (GTHA) to take a conversation to their communities about why transportation matters to people, and what actions they want governments to take to invest in a better regional transportation system.

Please fill out the following application form, and we will be in touch to provide additional information to successful applicants. * Indicates a required field

1. Please answer Yes or No to the following *This question is required.

Space Cell	Yes	No
Do you share CivicAction's vision of a strong, resilient, and prosperous region?
Do you support each of the following statements and agree to promote them within your community? a) "We need a regional transportation system for the GTHA that is accessible, affordable, efficient, and connected."
b) "Our governments are severely limited in providing more funds for transportation in the near term."
c) "We need to find new, sustainable, dedicated ways to raise money to develop a better transportation system."
Do you agree to be proactive in seeking out new opportunities to have this conversation within your community?
Do you view yourself as an influential leader in your community?
Will you remain non-partisan in your role as a local champion?
Do you commit to listening to your community and to gathering and relaying their feedback to CivicAction or its representatives when asked to do so?

2. Your Information

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required.

Phone Number *This question is required.

Mobile Phone

Street Address *This question is required.

City *This question is required.

Province *This question is required.

Postal Code *This question is required.

URL or Twitter

3. Current Role

Current Position *This question is required.

Organization *This question is required.

Organization Postal Code *This question is required.

Approximate number of people that you can reach with this campaign as a result of your involvement in the organization (e.g. employees, customers, members, students, etc.) *This question is required.

4. Why do you want to become a local champion? *This question is required.

5. What would make you an effective local champion? *This question is required.

6. Do you participate in other organizations or activities that you would like to engage in this campaign (e.g., clubs, associations, boards, etc.)? If so, what are they and how will you share messages with them? *This question is required.

7. Please state the approximate number of people that you could reach through each organization/activity mentioned above. *This question is required.

8. How did you hear about our campaign? *This question is required.

9. Do you have any additional comments that you would like to add?

Apply to be a Local Champion

CivicAction's "Your 32" Campaign