MyImpactPage - Application Form - MiWay Student Ambassador Program

Notice of Collection

Collection of Personal Information

Personal information on this form is collected under the authority of Section 11(1) of the Municipal Act, 2001 and will be used to determine eligibility for consideration in the Program, to correspond with Program entrants and for program administration purposes. In addition, the names of Program winners may be publicized for promotional purposes in accordance with the Program rules, subject to the entrant’s consent (or parent/guardian’s signature if under 18). Question about this collection should be directed to Lesley Swan, Senior Marketing Consultant, 3484 Semenyk Court, Mississauga, ON L5C 4R1 miway.ambassador@mississauga.ca, 905-615-3200 x5904.

I am new to MyImpactPage.com

You will need to enter a unique username to identify yourself to the system. You should select something that is easy for you to remember such as your email address or your name. Your username must be at least 6 characters long. If the name you enter is already in use by someone else, you will be prompted to choose another username.

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Email Address

Required

Verify Email Address

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I agree to the City’s notice of collection. Required

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If you have signed up with this organization before, or are a member of another organization that uses MyImpactPage.com, you can use the same login to access all organizations with which you are associated.

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Password	Required
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