Collaborative Health Governance Program Application

The Health Leadership Academy is committed to protecting personal information provided by customers. All information will be held in secure confidence by the Health Leadership Academy and its founders and will not be released without your express consent or as required by law. If you ever wish to withdraw your consent to our use of the information, you may do so by contacting us at hlainfo@mcmaster.ca.

Collaborative Health Governance Form

First Name(Required)

Last Name(Required)

Honorific

Title

Organization

University Designation

University Attended

Email(Required)

Phone

LinkedIn URL

Please confirm you meet the following criteria:

Regularly interact with a board

Understand the function of a board

Sit on a board of directors

Please share any experience you have working on or with a Board of Directors:

Please upload your:

Drop files here or

Accepted file types: pdf, docx, doc, Max. file size: 50 MB.

Resume Biography (2-3 paragraphs) and a copy of your CV.

The Collaborative Health Governance program qualifies as the equivalent to Module 1 of the Chartered Director program. If you wish to continue your governance journey with the Chartered Director program, please check the box below.

I am interested in more information on the Directors College, and can opt out of communication at any time.

I am interested in pursuing my governance journey with the Chartered Director program.

Please note that registration does not guarantee placement. Candidate profiles will be reviewed for suitability by Collaborative Health Governance selection committee. We will contact you about your application and next steps.

This field is for validation purposes and should be left unchanged.