Local Advisory Council

Do you want to have a voice in your community? SYNERGY NORTH is now accepting applications for The Local Advisory Council.

You can submit your application to serve on the Local Advisory Council by completing the form below, in addition to TWO completed Local Advisory Council Reference Forms.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Primary Phone Number *

Secondary Phone Number

I give permission for SYNERGY NORTH to communicate with my using the above given email address: *

Customer Class *

How did you hear about the Local Advisory Council?

Single Line Text

Why are you interested in being a member of the Local Advisory Council? *

Please outline any skills, experience or training that you feel may be an asset to the Local Advisory Council *

Please indicate your availability/preference for meeting time(s)

Please upload your TWO completed reference forms *

File Upload

Name