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2026 Council Election - Self-Nomination Form

Nominations are now being accepted for the upcoming Council election, and will continue to be accepted until Wednesday, September 2, 2026. Voting will begin October 6 and closes on October 22. The counting of votes will take place on October 27. Newly elected Council members will begin their three-year term on January 1, 2027.

An election will be held for the following district:

District 5 - Provincial District - 2 positions

In order for your self-nomination to be complete, you will be asked to copy and paste into this form the following items: a 250-word biography, a 100-word public protection statement, and a CV/Resume. Please have these ready before you begin the nomination form.


*Please note: The Nomination Form is subject to a review by College staff and that depending on the responses provided, it may not be accepted and staff will work with the nominee to address the the potential issues.
1.I consent to allow my name to stand for election as a Council member for the District in which I am running. In accepting this nomination, I affirm my commitments to the Duty and Objects of the College and undertake to comply with College By-Laws, Code of Conduct, Confidentiality, Conflict of Interest requirements and any other such College policies that apply to Council and committee members.
2.Please provide your contact information.
3.Confirm the District in which you are running.
Note: No Member shall be a candidate for Council Member in more than one district during an election. By-law 6.04(2)
Candidate Eligibility
4.Do you principally reside and/or practise in the electoral district for which you are seeking election?
5.Are you currently an employee, contractor, appointee, director, or officer of the Ontario Association of Optometrists, the Canadian Association of Optometrists, or any similar or comparable body?
6.Within the last year, have you been an employee, contractor, appointee, director, or officer of the Ontario Association of Optometrists, the Canadian Association of Optometrists, or any similar or comparable body?
7.Is your Registration certificate subject to any term, condition or limitation?
8.Are you in default of payment of any fees to the College?
9.Are you the subject of any disciplinary or incapacity proceedings?
10.Have you been disqualified as a Council/committee member in the last six (6) years?
Biography
11.Please provide the College with a short biography that outlines your academic, practice and volunteer experience (250-word limit). Please note, if your biography exceeds the word limit, we will truncate the excess wording and use the remaining text.(Required.)
Public Protection Statement
CV/Resume
12.Please copy and paste your CV/Resume into the text box below. There is no word limit for this section.
13.Describe an experience where you contributed to protecting the public interest (100-word limit). Where possible, emphasize how you were able to create a space or environment for multiple interests or perspectives to be shared in a constructive and collegial manner. Please note, if your statement exceeds the word limit, we will truncate the excess wording and use the remaining text.
Review the following information on roles and responsibilities for Council and committee members:

Understand and fulfill their role:

• demonstrate accountability through decision-making in the public interest;
• understand the division of roles and responsibilities of the Council or committee and staff;
• identify and address conflict of interest situations;
• recognize and respect confidential information obtained in the course of College activities as required by Section 36 of the RHPA;
• maintain constructive, collaborative and mutually respectful relations with Council members, committee members and staff; and
• maintain good relationships with members, healthcare organizations, educational groups and other stakeholders.

Possess the necessary knowledge:

• acquire and apply knowledge of Council and committee policies and procedures including relevant legislation, College values and strategic direction;
• maintain knowledge of College functions and issues facing Council or the committees on which they participate;
• review all material in advance of Council and committee meetings;
• identify information needed to enhance Council and committee discussions and decision-making;
• communicate concerns to Council or the committees on which they participate;
• communicate Council or committee decisions and rationale to individuals and groups as requested by the College.

Effectively participate in decision-making:

• arrange their personal schedule to allow attendance at meetings;
• contribute constructively to Council and committee discussions and decision-making;
• maintain positive working relationships with Council members, committee members, and College staff;
• identify and attempt to resolve concerns with the committee chairpersons;
• if the committee chairperson is unable to resolve the concern, address the concern to the College President;
• contribute to decision-making by identifying to the Chair relevant expertise or contacts;
• respect the specialized knowledge and expertise of other Council members, committee members and staff; and
• identify issues to be added to the Council or committee’s agenda in a timely and appropriate manner.
14.I confirm I have reviewed and understand the above noted responsibilities and expectations for Council members.
Confirmation
15.I confirm that the information contained in this Self-Nomination Form is complete and accurate. I will notify the College immediately should this information change.