Appendix 2A – Ownership Information – Campus

Instruction

The document must be saved under the name: Appendix 2A – Ownership Information – Campus.

1. 1. Proposed Licensee Name

   Option #1 - The proposed licensee is a non-profit corporation that has already been incorporated.

   Legal name on the Certificate of Incorporation: ___________________________

   Option #2 - The proposed licensee is a non-profit corporation that has not yet been incorporated.

   The application is submitted by _______ (Name of the individual submitting the application) on behalf of a non-profit corporation to be incorporated.

2. 2. Name of the associated post-secondary educational institution:

   ______________________

3. 3. Members of the Board of Directors (B.O.D.) and Chief Executive Officer (CEO)

   1. Please provide the list of members of the B.O.D. or, if not applicable, the individuals performing functions similar to those of such a position.
   2. Please provide the information regarding the person who holds the position of CEO. If such a position does not exist, indicate the name of the person who performs comparable functions and specify their title in parentheses.

Notes

• If the person who holds the position of CEO is also a member of the B.O.D., please provide their information in both sections.
• If a person identified in the table is a permanent resident, please indicate the approximate date on which they will be eligible to apply for Canadian citizenship in the “Canadian” column.

1. 4. Compliance with the Campus Radio Policy

   In Broadcasting Regulatory Policy 2010-499, the Commission specified that it expects that the Board of Directors for campus stations include campus representatives who provide balanced representation from:

   • the student body;
   • the administration of the post-secondary institution;
   • station volunteers; and
   • the community at large.

   In light of the above, please provide a detailed description of the measures taken to ensure that the structure and composition of the Board of Directors comply with the policy, or the reasons why the policy should not apply to your station.

Date modified:

2026-05-14