Application to Become a Director

Contact Information





 





Qualifications

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.

Review of Director’s Responsibilities

I understand that if I am appointed as a Director of the Corporation:








Profile

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.





Interest in the Corporation

Résumé

Conflict of Interest

References

List names, addresses and telephone numbers of three (3) people who will act as a reference for your application.

Reference #1



Reference #2



Reference #3



Declaration

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.

Contact Us:

Cheryl Vainio
cheryl.vainio@nbrhc.on.ca

North Bay

50 College Drive,
P.O. Box 2500
North Bay, ON
P1B 5A4
Tel: 705-474-8600

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Sudbury

680 Kirkwood Drive,
Sudbury, ON
P3E 1X3
Tel: 705-675-9193
Fax: 705-675-6817

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