CPATH Committee Membership Application Form
Contact information
 Name:

Preferred pronoun(s):

Email address:

Phone number:

Professional Designation/Governing Body (if any):

Are you a current CPATH member? If yes, what kind?
(for the list of CPATH membership categories, please visit
http://www.cpath.ca/membership/categories)

Can we call you at this number? Is it ok to leave a voicemail? Yes / No

What’s the best way to reach you? Email / Phone

What province/territory do you live in? (If you live outside of Canada, please
tell us your city and country.):

What language(s) do you feel comfortable communicating in?
 French
 English
 Other (please tell us
which one/s)
Which CPATH committee(s) do you want to join?
 1st choice:
 2nd choice (optional):
 3rd choice (optional):
Advocacy
CPATH committees currently seeking members
Community Communications Conference Education Translation
of Practice
Support
Tell us why you’d like to be part of the CPATH committee(s) you want to join
(250 words max.)
Why are you interested in being part of this CPATH committee(s)? What do you hope
to contribute to this committee? What do you hope to gain from the experience?
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Tell us about what you would bring to the committee (250 words max.)
Please share any relevant professional, volunteer, or personal experience with us.
(If you have a resume or CV please attach it.)
While most of the CPATH committees currently have co-chairs in place, if
there is a co-chair role available, would you be interested in having a
leadership role?
Yes / No
If yes, what relevant leadership experience do you have? (150 words max.)
How much time each month (# of hours) are you able to dedicate to your
CPATH committee work (please note that individual committees may have
minimum time expectations)?
Please provide us with the names and contact information for 1-2 references.
(personal or professional references – we recommend that you choose people who can
speak to how your qualities, skills, and experiences would be a great fit for this CPATH
committee, and how you function as part of a team.)
Please email your completed application form (and any
related documents) to info@cpath.ca.
Please note that the co-chair(s) of your desired committee(s) may contact you to
request further information specific to the committee’s mandate and activities.
Committee co-chairs will review all applications and will communicate their
decisions to applicants.
Please note that although we invite you to fill out the application form in French or
English at this point in time each committee will conduct its business mainly in
English. This is due to the limited French language capacity that currently exists
within our volunteer-run organization. Over the next few years and with the
growing involvement of our francophone members, we hope to make CPATH a more
linguistically representative organization.
Thank you for your interest in being part of CPATH!
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