Complaints Investigation Committee Application Question Title * 1. Please provide your full name. Question Title * 2. Please provide your email address. Question Title * 3. Please provide your phone number. Question Title * 4. Please provide your address. Question Title * 5. Are you a Registered Nurse (RN) or Nurse Practitioner (NP) in good standing with the College?*Please note for this position you must be a Registered Nurse or Nurse Practitioner in good standing with the College.* Yes No Question Title * 6. What is your understanding about the work of the College of Registered Nurses and its mandate? Question Title * 7. Why are you interested in serving on the Complaints Investigation Committee? Question Title * 8. What would your education, skills, and experience bring/add to the Complaints Investigation Committee? Question Title * 9. Electronic signature and application certification Clicking this box serves as my electronic signature and certifies that all statements made on this application are true and complete to the best of my knowledge. I understand and agree that any misrepresentation, omission, or falsification of information provided may result in disqualification from the selection process. I understand that the information I have provided will be used to assess my suitability to serve on Committees and may be viewed and used by Council, the Selection Committee and College staff involved in the selection process. By electronically submitting this application, I hereby certify that I have read and agreed with these statements and conditions and authorize the College to use all information I have provided with my application for the above-noted purposes. Question Title * 10. Please upload your resume here in support of your application. Question Title * 11. Please upload any other documents here in support of your application. Done