We are thrilled you want to take part in the Synapcity Fall 2017 Civics Boot Camp
Thank you for your interest! The application form below is designed to help us learn a little bit about you and to help us ensure Civics Boot Camp participants represent the various demographics of Ottawa - our city. We strive to select a balance of gender, culture, income, age, location, skills/aptitudes, and understanding of civic issues.

The one main criteria we have is that you, as a participant, be able to attend every session to be eligible. Oh, and you must be 18 years of age or older. The Fall 2017 session is scheduled to run weekly on Wednesday evenings from October 25 - November 29, 2017 from 5:30 - 9pm. A light dinner will be served so we may "share bread" as we begin each session.

If you have any questions or concerns, or would like assistance with your application form, please call Laine at 613-288-5810.
Email address *
First Name: *
Last Name: *
E-mail: *
Phone Number: *
Mailing Address: *
Postal Code:
To which gender identity do you most identify? *
Please select your age range *
What is your total household income: *
What languages are spoken at home? *
Which area of the city do you represent *
Why do you wish to participate in Civics Boot Camp? *
Are you coming to Civics Boot Camp to gain general knowledge or do you have a specific project idea in mind. *
What are the skills and talents you could bring to a group project on a community or municipal issue? *
If you have a specific project idea in mind, please share below:
What community or civic issues have you been involved with in the past? *
Please rate your level of understanding regarding civic engagement, 1 being low and 5 being high *
Much of the Civics Boot Camp experience is centred around group work, are you comfortable learning in this environment? *
We will be gaining knowledge on civic issues by exploring the following case studies. You will self select a case study group on the first day of Civics Boot Camp, but for now, please rate your interest in each. *
My First Choice
My Second Choice
My Third Choice
Revitalization, Neighbourhoods & Housing Shelters: The Salvation Army Re-Location
Built Environment/Newcomer Settlement: The Donald Buildings
Urban Forest Development Plan
Are you available to attend every session? Sessions run on October 25, and on November 1, 8, 15, 22 and 29. *
How did you hear about Civics Boot Camp? *
If you selected Other, please explain.
Transportation assistance with bus tickets is available for those who would not otherwise be able to attend. Do you require assistance with transportation? *
Do you require a child care subsidy? A limited amount of funds is set aside to enable those who would not be able to attend without a child care subsidy. *
Do you have any dietary restrictions? *
If YES, please explain?
Thank you! We will be in touch on October 11th with the status of your application.
Never submit passwords through Google Forms.
This form was created inside of Synapcity.