Application for Prospective Board Members
 

Stonegate Community Health Centre (CHC) is a multi-service centre providing comprehensive interdisciplinary primary health care, health promotion and community support. We are part of a network of Community Health Centres offering care to people facing barriers to accessing health care. By focusing on the broader determinants of health, we maintain a view to improving not only an individual's health, but the overall health and functioning of the community. We have a variety of programs and services for all age groups of diverse cultures.

Stonegate CHC is a charitable organization governed by a volunteer Board of Directors. We are looking for interested and experienced local residents to support the organization by joining the Board of Directors. Our objective is to have a Board that has a variety of skills and a diversity of experience to assure the continued effective functioning of the Board and the Health Centre. We try to ensure that the composition of the Board reflects the diversity of our community.

We are looking for creative and committed volunteers who are:
- Interested in taking a leadership role in the community
- Comfortable actively participating in group discussion at Board meetings
- Available to commit 5 to 10 hours each month including attending a monthly Board Meeting.

The Board of Directors role is to govern our organization. The core responsibilities include:
Leadership - creating the mission, vision, guiding principles and strategic goals and directions of the Health Centre.
Trusteeship - hiring and evaluating the Executive Director, recruiting and orienting new Board members and monitoring the financial position of the Health Centre.
Accountability to the Community - monitoring the performance of the organization, taking fiduciary responsibility and representing the organization to the community.

If you are interested in volunteering as a Board Member, please complete and submit this application. Our Executive Director, Beverly Leaver will be in touch to set up an interview with our Nominating Committee. If you have any questions, you can reach Bev at 416-231-7070 ext. 224 or at bev.leaver@stonegatechc.org.

The personal information provided in this application will be used strictly for the Board application process and will be shared only with members of the Board of Directors and the Executive Director.

1. Name:

2. Contact Information:

3. How did you hear about the volunteer opportunity on our Board of Directors?

4. Please tell us why you are interested in serving on Stonegate's Board of Directors.

5. To be effective, our Board must be made up of people with the knowledge, ability and commitment to fulfill their responsibilities. Although we provide an orientation to the role of Board Member we are seeking individuals with a variety of skills and experiences. We value life and volunteer experience as well as work experience. Please tell us about any education, volunteer, work or life experience that may give us an idea of the skills and experience you might bring to the Board.

6. Do your live in the Stonegate\Parklawn Community?
(At least 10 board members must live in our Defined Community defined as: Humber River to the east, Kipling Avenue to the West, the Queen Elizabeth Way to the South and Eglinton Street to the North)

7. Time Availability: Board Members are expected to attend Board meetings, Planning meetings and Special events. The Board currently meets on the third Monday of the month at 7 pm for approximately 2 hours. There are usually no meetings scheduled in July or August. Each member of our Board of Directors is also expected to be part of at least one Board committee. These are usually time limited commitments scheduled at the convenience of the Committee members. Are you available to regularly attend these meetings?

8. The Corporations Act limits eligibility to serve on a Board to people who are 18 years of age or older. Are you 18 years of age or older?

9. The Corporations Act limits eligibility to serve on a Board of Directors if you are an "undischarged bankrupt."
Can you confirm that you are not in the process of declaring bankruptcy?

10. Each Board member is expected to sign the following documents. Please indicate that you have been informed of the requirement to sign the following:

 AcknowledgeWish to discuss
A release to allow us to do a police reference check which also requires that we have two pieces of identification from you.
A Statement of Stonegate CHC Values and Responsibilities
A Board Privacy Statement acknowledging the ways in which we are required to share your private information (Name, Address, Birthdate.
A Confidentiality and Security of Corporate and Personnel Information agreement to not disclose private information at any time during the time you are a Board Member and after.
I also acknowledge that Board members are not eligible to apply for staff positions until twelve months after ceasing to be a Board member.