Candidate Form

Strong leaders and engaged community members are critical to the success of the Keystone Centre and are encouraged to complete the candidate form below.

Thank you for your interest in serving on the Keystone Centre Board of Directors. Please complete all sections of this form accurately. This information is for internal use only and will be treated with confidentiality.

Personal Information

Name(Required)
Name
Address(Required)
Email(Required)
Primary Phone(Required)
Preferred Method of Contact(Required)

Professional Background

Please enter a number from 0 to 100.
Briefly describe your professional background, expertise, and career highlights.

Community Involvement

Organization name, your role, and approximate dates.
Include organization name, role, and dates served.
Do you have any existing relationships with the Keystone Centre (e.g., tenant, partner, sponsor, user)?(Required)

Governance Experience & Competencies

Have you previously served on a board of directors?(Required)
1. Accounting/Finance 2. Governance Experience 3. Legal/Regulatory 4. Marketing/Communications 5. Human Resources 6. Strategic Planning 7. Agricultural/Environmental

Declaration & Signature

Conflict of Interest Disclosure: Are you aware of any actual or potential conflict of interest that may arise from your service on this Board?(Required)
Are you able to commit to attending regular Board meetings (approximately 10 times per year) and relevant committee work?(Required)
I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any misrepresentation may result in my application being disqualified. I consent to this information being reviewed by the Keystone Centre Governance Committee for the purposes of Board recruitment.(Required)
Date(Required)