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2025 Board Nomination Form
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1.
Contact Information:
(Required.)
Name
Company
Email Address
Phone Number
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2.
Desired role: (select all that apply)
(Required.)
Director, Regulatory & Policy
Chapter Chair - Bruce Chapter (non-voting Board Member)
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3.
Skills and Experience:
Directions: Rate yourself using a scale of 1-5 to reflect the level of experience possessed in a particular area.
If you select (4) OR (5) please use Question 4 to explain further.
1 – None
No formal education, experience, or competency in the area
2 – Basic
Basic understanding of the area, for example:
Has an educational background that allows for a basic understanding of the area
Some experience related to the area
Basic understanding of the principles of the area
Capable of following Board discussion of the area
3 – Competent
Competent understanding of the area, for example:
Means that you have experience in this field or that you have good skills in this area, you may have a degree, diploma, or designation, or at least a strong understanding of this area from a management perspective
Has education relevant to the area
Experience in fields related to the area
Competent grasp of principles of the area
Capable of contributing to Board discussions of the area
4 – Advanced
Advanced understanding of the area, for example:
Means that you have leadership experience in this field or that you have enough skill in this area to be paid for your work at a management level in this area, either through employment or as a consultant or teacher, you have mastered this skill
Has post-secondary education specifically relevant to the area
Possesses practical knowledge specific to the area and can meaningfully engage with practical questions
Capable of analyzing and explaining data and contributing significantly to Board discussions of the area
5 – Expert
Expert-level understanding of the area, for example:
Means that you have over 10 years full-time leadership experience in this field or that you would be considered an “expert” or “specialist” in this area by your peers and others who specialize in this skill
If available has a professional designation or postgraduate degree specifically relevant to the area
Extensive practical experience as an expert practitioner in the specific area in question
Extensive and up-to-date knowledge of trends and best practices in area - could function or is functioning as a high- level practitioner in the area
Capable of analyzing and explaining data, leading Board discussion, developing long-term strategy and challenging experts in the area
(Required.)
None
Basic
Competent
Advanced
Expert
Belief in/ Support of Mission
None
Basic
Competent
Advanced
Expert
Experience in Stakeholder Management
None
Basic
Competent
Advanced
Expert
Sponsorship/ Fundraising
None
Basic
Competent
Advanced
Expert
Communication Skills
None
Basic
Competent
Advanced
Expert
Previous service on a WiN Canada Committee, or in a WiN Canada Chapter
None
Basic
Competent
Advanced
Expert
Leadership Experience
None
Basic
Competent
Advanced
Expert
Project Management
None
Basic
Competent
Advanced
Expert
Marketing Skills
None
Basic
Competent
Advanced
Expert
Industry Connections
None
Basic
Competent
Advanced
Expert
Government Connections
None
Basic
Competent
Advanced
Expert
Knowledge of regulatory affairs of the nuclear industry including licensing activities
None
Basic
Competent
Advanced
Expert
Knowledge of federal and provincial policies and strategies that may impact of effect the nuclear industry
None
Basic
Competent
Advanced
Expert
Fiscal Management
None
Basic
Competent
Advanced
Expert
Organizational Management
None
Basic
Competent
Advanced
Expert
Risk Management
None
Basic
Competent
Advanced
Expert
Strategic Planning
None
Basic
Competent
Advanced
Expert
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4.
Please elaborate on your experience here:
(Type N/A if you did not select 4 or 5 in Question 3)
(Required.)
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5.
Please upload your Resume / CV (PDF):
(Required.)
Choose File
No file chosen
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6.
Please upload your Photo / Headshot (PNG, JPG, JPEG):
(Required.)
Choose File
No file chosen
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7.
Reference from a WiN Canada Member (PDF, DOC, PNG, JPG, JPEG):
(Required.)
Kindly upload the reference provided by a WiN Canada Member
Choose File
No file chosen
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8.
Statement of Intent: (300 words max)
Please tell us why you are interested in the role(s) you selected in Question 2.
(Required.)
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9.
Demographic Background
Preferred Pronouns:
(Required.)
He/ Him
She/ Her
They/ Them
Prefer not to respond
Other (please specify)
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10.
Acknowledgements
(Required.)
I acknowledge that I have received confirmation of manager support.
I acknowledge/commit to
WiN Canada's Ethical Behaviours and Fundamental Principles