Kwantlen Polytechnic University Alumni Association (KPUAA) Elections
Board of Directors – Candidate Form 2015
Date:
*Please note that any incomplete applications, including applications submitted without the required
supporting documentation will be considered invalid.
APPLICANT NAME:
Title:
First Name:
Last Name:
EDUCATION INFORMATION:
Kwantlen Credential:
Year:
Student Number:
Other Credential:
Year:
School:
Other Credential:
Year:
School:
CONTACT INFORMATION:
Home Address:
City:
Home Phone:
Prov:
Postal Code:
Mobile Phone
Personal Email:
EMPLOYMENT INFORMATION:
Employer Name:
Title:
Business Phone:
Work Email:
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Kwantlen Polytechnic University Alumni Association (KPUAA)
Elections Board of Directors – Candidate Form
MEMBERSHIPS IN PROFESSIONAL ORGANIZATIONS:
Organization Name:
Organization Name
PREVIOUS BOARD AND/OR VOLUNTEER EXPERIENCE
Organization Name:
Position:
Term of Service:
Organization Name:
Position:
Term of Service:
ALUMNI INFORMATION
Please describe your past involvement with Kwantlen:
Please describe your interest in joining the Kwantlen Alumni Association Board of Directors:
All successful candidates who are appointed to the board following the election are required to serve on at
least 2 committees. Here is a list of KPUAA’s current committees. If you would like detailed terms of
reference for any of the committees, please email alumni @kpu.ca.
Alumni Engagement
Executive
Governance
Risk Management
Tributes/awards
Sponsorship
Other (ad-hoc basis)
Kwantlen Polytechnic University Alumni Association (KPUAA)
Elections Board of Directors – Candidate Form
CANDIDATE STATEMENT:
I understand that the Alumni Association and Kwantlen Polytechnic University have an obligation to verify
reference information with respect to all candidates for potential appointments, including myself.
By signing below, I authorize the Alumni Association and Kwantlen Polytechnic University to verify or obtain
personal information about me directly from me, from organizations or references referred to in this
application for the purpose of evaluating my suitability for appointment to the Board of Directors for the
Alumni Association.
If I am a successful candidate, I allow my name to stand for nomination for the KPUAA Board of Directors
election taking place in this calendar year.
I agree that if I am elected for a position on the Board of Directors, the Alumni Association and Kwantlen
Polytechnic University may publish a biography of me that contains information provided in this application.
Signature:
_____________________
Date:
_____________
Please submit the following information with your application:
Résumé outlining education, occupation, volunteer experience, professional interests and
achievements. (Required)
Exec
Biography (150 words or less) to be used on the website for the purpose of this election if you are a
successful candidate. (Required)
Risk
A professional
Anylooking
other supporting
photo (headshot)
documentation.
of yourself
(Optional)
that will be uploaded with your bio for the
online election. If we do not receive a photo from you, just your bio will be uploaded.
Any other supporting documentation. (Optional) Supporting documents must not exceed 5 pages.
Please email your completed form and any supporting documentation to alumni@kpu.ca by September 13th,
2015.
For more information about the KPU Alumni Association and the elections, please contact Shina Boparai,
Advancement Officer - Alumni Relations at (604) 599-3158, or by e-mail at alumni@kpu.ca
Any