2024 Call for Nominations Form (Board – Patient Member)

Canada’s Drug Agency actively celebrates, supports, and flourishes through our differences. Our Board Members are people with different strengths, experiences, and backgrounds, who share a passion for building the future of health care. We highly encourage all qualified applicants to apply, including people of all places of origin and religions; people with disabilities; people who are neurodivergent; people who are Black or racialized; First Nations, Inuit, and Métis People; women; and people from the 2SLGBTQ+ community. 

Accommodations are available during all phases of the recruitment process. If you require any accommodation or have any questions, please contact Arni Ahronson, Vice-President, People and Culture ([email protected]).
 

Please provide the following information:

Nominee Contact Information

How did you hear about the Call for Nominations?
If I am not selected for the Patient Member role on the Board of Directors, I am interested in being considered for another board position or role with Canada’s Drug Agency.

Eligibility

Individuals must meet all the following requirements to be eligible as a Board Director:

  • be older than 18 years of age
  • not been declared incapable by a court in Canada or in another country
  • not have the status of bankrupt
  • reside in Canada.

Do you meet all these eligibility requirements? (*Required)

Patient Member Role

Identify which of the following areas you have experience in (refer to the role description for definitions). Please check all that apply: (*Required)

Supporting Documentation

Please ensure you have reviewed the role description before completing and uploading your documents.

Instructions:

  • Attach your documents in the "Attached File" upload area that follows.
  • Please zip your files if you are uploading more than one file.

Note: If you have technical issues with our form or have other questions, please contact [email protected]

Choisir un fichier
Files must be less than 10 MB
Allowed file types: txt, pdf, doc, docx, zip.
Download and save a copy of the Statement of Interest and Qualifications form to your computer. Complete your form and upload a copy here.
Choisir un fichier
Files must be less than 10 MB.
Allowed file types: txt, pdf, doc, docx, zip.
Please include a document that identifies 2 references who can be contacted if you are selected to proceed in the selection process.
Choisir un fichier
Files must be less than 10 MB.
Allowed file types: txt, pdf, doc, docx, zip.
  • 1 seul fichier.
  • Limité à 10 Mo.
  • Types autorisés : txt, pdf, doc, docx, zip..

Nomination

While we thank all nominees for their interest, only those under further consideration in the process will be contacted personally by email.

Candidates who are invited to an interview will be required to complete a conflict of interest declaration form.

The information provided in the nominations package is being collected for the sole purpose of recruiting and selecting members for the organization’s Board of Directors.

By selecting “Yes,” I acknowledge that and consent to the information provided in my nominations package being collected for the purpose identified. (*Required)
I consent to the information provided in my nominations package being kept on file by the organization for up to 3 years for the purpose of recruiting and selecting members for the Board of Directors, expert and advisory committees, and other related roles. (*Required)
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