Join the Emerging Leaders Network
Are you an emerging leader looking to grow your network, build your leadership toolkit, and collaborate on solving our region's most pressing civic issues? Then it's time to sign up for CivicAction's
Emerging Leaders Network
(ELN)!
The ELN connects, develops, and activates rising leaders from across the Greater Toronto and Hamilton Area (GTHA). By filling out this short registration form, you'll be added to our monthly newsletter and will get first access to sign-up for our programming.
REGISTRATION
1. First Name
2. Last Name
3. Email Address
4. Sector with which you most closely identify
Please select...
Public
Private
Non-profit
Labour
Other
5. Organization or group where you identify as a rising leader
(this may be where you work or volunteer)
6. Title/role at that organization or group
7. City or regional municipality where you
work
Please select...
Durham (Ajax, Brock, Clarington, Oshawa, Pickering, Scugog, Uxbridge, Whitby)
Halton (Burlington, Oakville, Milton, Halton Hills)
Hamilton
Peel (Brampton, Mississauga, Caledon)
Toronto
York (Aurora, East Gwillimbury, Georgina, King, Markham, Newmarket, Richmond Hill, Vaughan, Whitchurch-Stouffville)
8. City or regional municipality where you
live
:
Please select...
Durham (Ajax, Brock, Clarington, Oshawa, Pickering, Scugog, Uxbridge, Whitby)
Halton (Burlington, Oakville, Milton, Halton Hills)
Hamilton
Peel (Brampton, Mississauga, Caledon)
Toronto
York (Aurora, East Gwillimbury, Georgina, King, Markham, Newmarket, Richmond Hill, Vaughan, Whitchurch-Stouffville)
9. What is your primary reason for joining the ELN?
Please select...
To grow and diversify my network
To develop my leadership skills
To gain a deeper understanding of civic issues
To gain awareness about community engagement opportunities
To engage with CivicAction’s network and work
To make our region more inclusive and accessible
Not sure which regional municipality you live/work in? Take at a look at this
map of the GTHA
.
DEMOGRAPHIC DATA
The following questions are asked to help ensure we are offering programming that reflects the diversity of our membership. The information requested will only be used for internal purposes and will not be publicly distributed or shared.
10. Birth year
11. Which of the following best describes your gender? Please select all that apply
Please select...
Female
Male
Non-Binary/ Third Gender
Transgender
Not Listed.
I prefer not to disclose
If you selected "Not Listed", please specify:
12. Do you self-identify as an Indigenous person in Canada such as First Nation, Métis, or Inuit?
Yes
No
I prefer not to disclose
If yes, please select all that apply
Please select...
Inuit
Métis
First Nations
I prefer not to disclose
13. Do you self-identify as a member of a racialized group?
Yes
No
I prefer not to disclose
If yes, please select all that apply
Please select...
Black (e.g. African descent, Afro-Caribbean descent, African-Canadian descent)
African, Indo-Caribbean (eg: East Indian from Guyana, Trinidad, etc.)
Latinx / Hispanic (e.g. Latin American, Hispanic descent, including Indigenous)
East Asian (e.g. Chinese, Korean, Japanese, Taiwanese descent)
South Asian (South Asian descent, e.g. Indian, Pakistani, Bangladeshi, Sri Lankan, etc.)
Southeast Asian (e.g. Filipino, Vietnamese, Cambodian, Thai, Indonesian, other Southeast Asian descent)
Middle Eastern (Arab, Persian, West Asian descent, e.g. Afghan, Egyptian, Iranian, Lebanese, Turkish, Kurdish, etc.)
White (eg: European descent)
Not listed.
Prefer not to disclose
If you selected "Not Listed", please specify:
14. Do you self-identify as a person with a disability?
Yes
No
I prefer not to disclose
If yes, please specify:
15. Do you self-identify as someone in the 2SLGBTQIA+ community?
Yes
No
I prefer not to disclose
If yes, please select all that apply
Please select...
Lesbian
Gay
Bisexual
Trans
Queer
Two-spirited
Intersex
Asexual
I prefer to self-describe
I prefer not to disclose
Please self-describe:
Thank you for registering!
Contact Information