First Name: Last Name:

Phone: Email:

Address:

City: Prov: Postal Code:

Areas of interest:

Why would you like to be a part of the Flex Council?

What do you feel you can add to the Flex Council?

Describe any relavant experience you may have / tell us about yourself:

Thank you for your interest in Flex. We will contact you within 7 days to further discuss your application.