Expert-in-Residence Application

Please complete all questions on this application and supply any additional requested information.

Part I. General Information

First Name*

Last Name*

Job Title*

Company Name*

City*

Province or State*

Phone Number*

Email*

LinkedIn URL

Part II. Sector Expertise

Industry Knowledge - Only check the ones that apply.

Waste Management

Agriculture, Forestry, Fishing and Hunting

Aquaculture

Finance

Insurance

Healthcare

Hospitals

Electric Power Generation, Transmission, and Distribution

Farm Products

Food, Beverage, and Tobacco

Pharmaceuticals, Toiletries, Cosmetics and Sundries

Building Materials and Supplies

Machinery and Equipment

Computer and Communications Equipment

Paper, Paper Products, and Disposable Plastic Products

Agriculture Supplies

B2B Electronic Markets, Agents and Brokers

Functional Skills - Only check the ones that apply.

Communications

Public Relations

Corporate Communications

Crisis Management

Distribution

Channels

Distrubution - intensive, selective, exclusive

Part III. Background and Experience

Please upload your resume in .doc or .pdf form.*

What size of companies make up the majority of organizations you have advised: *

Please describe your experience in entrepreneurship or working with startups.

Part IV. Motivation

Please share why you are interested in being an EXIR with the Innovation Cluster.*

Part V. Representation

As an Expert-in-Residence candidate, you understand that you will provide your best technical and subject matter guidance without prejudice to your own company or employer.*

Yes

As an EXIR candidate, you agree that any compensation you may receive from the Innovation Cluster for your time will be at a standard hourly rate.*

Yes

Part VI. Eligibility Criteria

EXIR candidates are advised that to remain eligible for consideration as an EXIR, each applicant must meet the following criteria:

Shall be an individual who:
- is at least 18 years of age;
- has not been found by a court in Canada or elsewhere to be mentally incompetent, and
- does not have the status of a bankruptcy.

By submitting this application, resume/CV and cover letter, you declare that:

You meet the eligibility criteria.
You certify that the information in this application and in my resume is accurate and true.
You agree to abide by the policies and procedures of the Innovation Cluster – Peterborough and Kawartha Lakes.

The undersigned grants the Innovation Cluster permission to contact references and conduct background checks.

Year-Month-Day

Signature

APPLICATION SUBMISSION: Please submit this form and résumé/CV to board@innovationcluster.ca.

The Innovation Cluster is strongly committed to equity and inclusion within the community and encourages applications from all qualified candidates, including Persons of Colour, Persons with Disabilities, Indigenous, and LGBTQ+ community members.

We thank all applicants in advance, however, only those selected for an interview will be contacted. For more information about the role – please contact Board@innovationcluster.ca