Nomination Form for Doctors of BC's 2024 Elections

Nomination Form for Doctors of BC's 2024 Elections
This is your opportunity to stand for election for the positions of President-Elect and Elected Delegates on the Representative Assembly (RA) - positions nominated and elected by the membership.

It is also your opportunity to stand for election for the Board of Directors, Audit and Finance Committee, Governance Committee, and Nominating Committee – positions nominated by the membership and elected by the RA.

Please note that completed nomination forms must be submitted by the candidate before 11:59pm on Monday, October 21, 2024.

All candidates and nominators must be members in good standing in a category eligible to hold office and vote. Ordinary Members are eligible for all positions; Professionally Inactive Members are eligible for Committee positions only.

If you have any questions or run into any technical difficulties, please contact voting@doctorsofbc.ca or Katie Karn, Director of Governance, at kkarn@doctorsofbc.ca.
** Please ensure all fields of the Nomination Form are completed to avoid any delay in the review/acceptance of the nomination **
- Candidate's Information
- Name
  
  First NameLast Name
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Demographic Information
- Enter Specialty or Practice Focus (if any)
- Please select which position(s) you are running for:
  
  President-ElectFamily Physician - District 6 (South of the Fraser)Family Physician - District 8 (East/West Kootenays)Specialist - District 9 (Skeena)Specialist - provides services in a rural community within the scope of the Rural Subsidiary agreementFamily Physician - provides services to First Nations Health Authority or in other Indigenous health contextsSpecialist - provides services to First Nations Health Authority or in other Indigenous health contexts
- Nominators' Information
- I, Candidate First Name Candidate Last Name Doctors of BC ID, confirm that I have secured the nomination of the following TWO nominators:
- Nominator #1 First Name Nominator #1 Last Name, Nominator #1 Doctors of BC ID, a Doctors of BC member in good standing.
- Nominator #2 First Name Nominator #2 Last Name, Nominator #2 Doctors of BC ID, a Doctors of BC member in good standing.
- Candidate's Information
- Name
  
  First NameLast Name
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Demographic Information
- Enter Specialty or Practice Focus (if any)
- Please select which position(s) you are running for:
  
  Board Director at LargeAudit & Finance Committee Member at LargeGovernance Committee Member at LargeNominating Committee Member at Large
- Nominators' Information
- I, Candidate First Name Candidate Last Name Doctors of BC ID, confirm that I have secured the nomination of the following TWO nominators:
- Nominator #1 First Name Nominator #1 Last Name, Nominator #1 Doctors of BC ID, a Doctors of BC member in good standing.
- Nominator #2 First Name Nominator #2 Last Name, Nominator #2 Doctors of BC ID, a Doctors of BC member in good standing.

Nomination Form for Doctors of BC's 2024 Elections

Candidate's Information

Nominators' Information

Candidate's Information

Nominators' Information