Board of Directors Candidate - AMI-Quebec

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Board of Directors Application Form

Are you interested in being on our Board of Directors, or would you like to nominate someone? Please complete the form below, or click here for a downloadable form.

Board Candidate

Candidate Name*
Address*
Street Address Address Line 2 City Province Postal Code
Occupation*
Email*
Phone*
Candidate is: (please check one)*
- Family Member (Parent, spouse, sibling, child or loved one of someone with a serious mental illness)
- Primary Consumer (An individual with a diagnosis of mental illness)
- Mental Health Provider
Areas of Knowledge/Expertise/Influence*
Please select all that apply
- Business Management
- Not-for-Profit Management
- Personnel Administration
- Marketing/Public Relations
- Accounting/Finance
- Law
- Education K-12
- Education, College/University
- Clergy/Lay Church Work
- Medicine/Psychiatry
- Psychology
- Social Work
- Child/Adolescent Mental Health
- Politics/Legislation/Advocacy
- Fund Raising
- Community Development
- Corrections
- Information technology (IT)
- Other
What is your experience/familiarity with AMI-Quebec?*
List previous volunteer and/or board member experience:*
List outside interests that may be relevant to the AMI-Quebec mission:*
What does the candidate bring to AMI-Quebec?*
If filled out by person other than candidate, please note this page is confidential and will not be shared with candidate.
Candidate proposed by*
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Phone
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AMI-Quebec Action On Mental Illness

AMI-Quebec helps families manage the effects of mental illness through support, education, guidance, and advocacy. Our programs are free!

5800 boul. Decarie, Montreal, Quebec H3X 2J5

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