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* 1. Full name:

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* 2. Business address:

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* 3. Home address:

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* 4. Home phone:

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* 5. Business phone:

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* 6. Cell phone:

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* 7. Email address:

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* 8. Please list current or prior board experience: 

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* 9. Which areas of board work are of particular interest to you?

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* 10. What skills/areas of expertise can you bring to the RVH Board? 

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* 11. Please describe your background and experience that is related to the affairs and operations of the hospital. 

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* 12. At RVH, we value diversity and intersectionality. If comfortable, please let us know your cultural background and/or how you identify. 

Thank you for filling out the application form. Please email your cover letter and CV to boardofdirectors@rvh.on.ca

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