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I, the undersigned, hereby apply to be considered for appointment as a Director of the Corporation, and in doing so, acknowledge and declare that:
If you have responded YES to any of the above questions (1 through 6), unfortunately you are not eligible for election or appointment as a Director of the Corporation.
I understand that if I am appointed as a Director of the Corporation:
I will support the objects, mission and vision of the Corporation.
I will act honestly and in good faith, in the best interests of the Corporation.
I will advise the Corporation if there is a circumstance that would cause me to automatically vacate the office of Director.
I will abide by the conflict of interest and confidentiality provisions governing Directors.
I will cooperate and assist the Board to fulfill its responsibilities to the Corporation.
I have the time to devote to preparing for and attending Board and Committee meetings on a regular basis (approximately 15 to 20 hours per month). Board of Directors meet on the second Thursday of the month. Committees meet as follows: Quality – 3rd Wednesday of the month; Resource, Finance & Audit – 4th Wednesday of the month; Governance – 4th Thursday of the month. The average duration for the Board and Committee meetings is 3 hours.
I will attend orientation and training sessions as a new Director.
I understand that I will not be compensated for my services as a Director (as required by law), although I may be reimbursed for out-of-pocket expenses incurred.
I understand that the Corporation wants to ensure that its Board of Directors has a broad range of skills, expertise and community interests. To assist the Corporation in establishing a Board that reflects a cross-section of the community, I am providing the information requested below (all questions are optional to answer):
Please complete the attached Skills Matrix and return with the application.
Please describe your interest in serving as a Director of the Corporation and any other information you would like to offer.
I attached a copy of my current résumé. (10MB Max)
Below I disclose my participation or affiliation with any organizations that may create an actual or perceived conflict of interest with the Corporation:
List names, addresses and telephone numbers of three (3) people who will act as a reference for your application.
If my application is approved, I agree to act as a Director of the Corporation and, in my capacity as a Director of the Corporation, I shall at all times act honestly and in good faith, in the best interest of the Corporation and abide by the Corporation’s By-Laws and all governing legislation. I understand that the term that I may serve as a Director is to be determined. I fully understand that any errors in my application may result in my application for consideration as a Director being refused or my Directorship being revoked. I undertake to advise the Corporation immediately in writing of any change in information contained in this Application.
50 College Drive,
P.O. Box 2500
North Bay, ON
680 Kirkwood Drive,
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