The SGO and Foundation for Gynecologic Oncology operate under the same leadership, thus the SGO Board of Directors
also serves as the Council for the Foundation for Gynecologic Oncology. Thank you for your interest in serving the SGO
and its Foundation.
Eligibility Requirements and Position Descriptions
President Elect II
The President Elect II must be a Full Member in good standing. Multidisciplinary and international Full Members are eligible.
The President Elect II serves a one-year term and automatically ascends to the position of President Elect I and to President
of the SGO. The President Elect II executes the duties of the Secretary-Treasurer in the absence of the Secretary-Treasurer
and Secretary-Treasurer-Elect. The President Elect II will also serve as chair to the SGO Health Policy and Socio Economic
Committee. After Presidency, this individual continues to sit on the Board and Executive Committee for one year as Past
President. The Past President chairs the Nominating Committee and Honors & Awards Committee. The total time
commitment is four years.
Secretary-Treasurer Elect
The Secretary-Treasurer Elect must be a Full Member in good standing. Multidisciplinary and international Full Members
are eligible. The Secretary-Treasurer Elect serves a two-year term and succeeds to the office of the Secretary-Treasurer
for an additional two-year term with the recommendation and approval of the Nominating Committee. The SecretaryTreasurer Elect also chairs the Finance Committee for both the SGO and Foundation. The total time commitment is four
years.
Board/Council Member (three open positions)
Board/Council Members must be Full Members in good standing. Multidisciplinary and international Full Members are also
eligible. Board/Council Members serve one three-year term of office and will be appointed to sit on at least one SGO
Committee as a Liaison.
Candidate and Fellow-in-Training Member Representatives
Candidate and Fellow-in-Training Representatives to the Board must be Candidate and Fellow-in-Training Members,
respectively. Candidate and Fellow-In-Training members must be in good standing and hold the same member level for the
duration of their appointment (March 2015 – March 2016). These representatives serve a one-year term of office and do
not hold voting rights.
Instructions
Materials
Complete the following application questions, disclose any potential conflicts of interest, and submit the following:
 High resolution digital photograph (portrait/headshot)
 Letter of support from the Fellow’s program director. (Fellow-in-Training applicants ONLY. Recommendation letters are
not required and will not be accepted for any other position.)
Deadline & Submission
11:59 p.m. CT, Friday, Nov. 6 2015. Late applications will not be accepted. Email the completed application and materials
to jennifer.ocampo@sgo.org.
Completed applications will be reviewed by the SGO Nominating Committee. Applicants will be notified of their status the second week
of December. The slated candidates will have seven (7) days to review and submit their personal statement for the election based on the
submission for application question number 5. Elections will be open Jan. 11 – Feb. 12, 2016. Slated candidates will be notified of the
election results by March 1, 2014.
Questions: Contact SGO’s Manager of Governance and Membership, Jennifer Ocampo at (312) 676-3916 or jennifer.ocampo@sgo.org.
Name:
Institution:
Professional Title:
Phone Number:
Email Address:
SGO Member Type:
Position Applied for:
Full Member
President Elect II
Candidate Member
Secretary-Treasurer Elect
Expected Board Certification Year:
Fellow-in-Training (FIT) Member
FIT Graduation Year:
Board Member
Candidate Member Representative
Fellow-in-Training Representative
1. List past or current SGO Committee or Council Service: (list dates and positions held)
(Start typing in the shaded area. The boxes will expand as you type.)
2. List prior or current service on other organizations’ Committee or Board of Directors. Have you held a leadership role in
any other health-related organization? List dates and positions held.
3. What do you think are the most important issues and challenges facing SGO members (professionally) and the Society
(organizationally) in the next few years? Why? What strategies would you employ to address these issues?
4. Have you had experience creating and working with a budget? Please describe.
5. Why do you want to serve as a member of the SGO Board of Directors and Foundation Council? What do you hope to
accomplish should you be elected? What specific leadership traits are your strengths and how could your leadership
qualifications and experience benefit the SGO and its Foundation?
This question will be used as your personal statement and provided to the SGO Members should you be chosen for the slate. If you
are selected for the slate, you will have 7 days to review this statement and you will be asked to limit it to 250 words.
CONFLICT OF INTEREST DISCLOSURE QUESTIONS
In order for the SGO to further the purposes for which it was organized and maintain its excellent reputation, it is important that Society decisions and
actions not be influenced unduly by any special interests of individual members. The Society depends upon the Board to shape its policies, and the actions
of those members must not be inappropriately affected by outside influences. Therefore, it has always been and continues to be important to identify actual
or potential conflicts of interest which might improperly affect Society activities and decisions.
We ask that you complete the following and disclose any potential conflicts you may have. It is the responsibility of the Nominating Committee to review
potential conflicts and take them into consideration while compiling the slate. Potential conflicts may not hinder your chances of being selected, but it is
important that the Nominating Committee be made aware of them.
All Board/Council Members and Officers must adhere to SGO’s Conflict of Interest and Dissociation Policy.
1.
OUTSIDE INTERESTS: Identify any position that you, a business associate or a member of your immediate family has,
including but not limited to a board, officer, or consulting position, in any concern from which the Society or its members obtain goods or
services.
2.
AFFILIATIONS: List officer positions, director positions, editorial positions, committee positions or status as a paid or non-paid
consultant in any health-related association, certifying or accrediting organization, or health-related business concern, specifically
including professional associations comprised principally of physicians certified by the American Board of Obstetrics and Gynecology
and companies providing goods or services to those physicians.
3.
FINANCIAL INTERESTS; KEY POSITIONS: List and describe with respect to you and any member of your immediate family
financial interests held in any health-related business concern, defined as a for-profit entity that produces, markets or distributes drugs,
devices or services used by members of the Society in the treatment of patients, and/or a position as officer, director, managing partner
or key employee of a health-related business concern. Please identify the range of the financial interests, e.g., $0 to $10,000; $10,000
to $50,000; $50,000 to $100,000; greater than $100,000.
4.
COMPENSATION: Identify support from any health-related business concern or other source, including any publishing,
internet or e-commerce organization, engaged in the health care field. Support includes salary, consulting fees, expert witness fees,
stock options, royalty arrangements, or dividends, or payment for speaking engagements (exclusive of reimbursable travel costs).
Please identify the range of the support, e.g., $0 to $10,000; $10,000 to $50,000; $50,000 to $100,000; greater than $100,000.
5.
INDUSTRY-SPONSORED GRANTS, INCLUDING CONTRACTED RESEARCH: List the health-related business concern and
the amounts paid or anticipated to be paid to you, members of your practice group or academic department during any 12-month
period. Please identify the range of the support, e.g., $0 to $10,000; $10,000 to $50,000; $50,000 to $100,000; greater than $100,000.
6.
OTHER: List any other interests or activities in which you or your immediate family is engaged which might be regarded as
constituting a conflict of interest or a potential conflict of interest.