LHSC Board of Directors - Expression of Interest

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Section 1: Eligibility Declaration

To be eligible for appointment to the Board of Directors, you must not be an "Excluded Person" as defined by the LHSC By-laws and/or the Not-for-Profit Corporations Act, 2010 (Ontario).

Please review and confirm each statement by selecting the box beside it:

*1. Vendor/Contractor Relationship

I do not currently provide goods or services to LHSC (directly or through a corporation)
I am not a director, owner, operator, major shareholder, senior executive, or corporate officer of an entity that:
is currently under contract with LHSC;
has responded to an LHSC Request for Proposal (RFP) in the previous fiscal year;
or intends to submit a proposal to LHSC during my potential term as a Director.

*2. Current Employment or Professional Staff

I am not a current or former employee of LHSC.
I am not a current or former credentialed professional staff member of LHSC.

*3. Family/Household Relationship

I am not a family member* of a current LHSC employee or currently credentialed professional staff member.
I do not live in the same household as a current LHSC employee or currently credentialed professional staff member.

(*Family Member means the spouse, partner, parent, child, brother or sister of a current LHSC employee or currently credentialed professional staff member.)

*4. Additional Legal Eligibility Requirements

I am at least 18 years of age.
I have not been found incapable of managing property under applicable law.
I have not been declared incapable by a court.
I am not an undischarged bankrupt.
I am not an "ineligible individual" under the Income Tax Act (Canada).

*Final Eligibility Confirmation

I confirm that I am not an Excluded Person and meet all eligibility requirements.
I understand that if my circumstances change, I must immediately disclose this to LHSC.
I understand all candidates recommended for appointment or election to the LHSC Board of Directors must successfully complete a Criminal Record Check prior to appointment.

If you are unable to confirm ALL of the above, you are not eligible to apply.