ISOQOL Board of Directors Application

ISOQOL Board of Directors Application
Background Information and Directions
Thank you for your commitment to ISOQOL and for participating in the Board candidate application process. Your contributions to the organization are greatly valued.

This application is divided into four sections:
1. Candidate Application (a series of questions to be answered by each candidate)
2. Election Statement
3. Conflict of Interest Disclosure (please identify any actual or perceived conflicts)
4. File Uploads (professional photo and CV)
The information you provide will assist the ISOQOL Nominations Committee in identifying a slate of qualified and diverse candidates for the open positions on the Board of Directors.

If you have any questions regarding the candidate application or nominations process, please contact the ISOQOL Office at info@isoqol.org.

Please be advised that completing this application will require a significant investment of your time. We recommend reviewing the PDF copy of the application and drafting your responses in a Word document prior to starting the electronic submission process. However, please note that all applications must be submitted electronically through the web form.

Section 1: Candidate Application

Please provide your contact information below.
Name*

First NameLast Name
Current Employment/Company: *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Links to employer, ResearchGate and/or LinkedIn profiles (Optional):
Indicate Nomination Type*

Self-nominationNominated by a colleague
Position for which you agree to be a candidate*

Director-at-LargePresident-Elect
Other Leadership Opportunities:
Submitting an application for the ISOQOL Board of Directors does not ensure placement on the election ballot. The ISOQOL nominations committee evaluates applications based on qualifications and seeks to address any gaps on the Board to ensure fair representation of the membership. In the event you are not included on this year's ballot, we encourage you to try again next year. There are also several other leadership opportunities available within ISOQOL, such as committees, task forces, Special Interest Groups (SIGs), and journal editorial boards.
Please indicate if you would like to be contacted regarding those leadership roles.*

Yes, please contact me.No, I do not wish to be considered for a different Leadership position.
Please complete the information below to assist the Nominations Committee in reviewing your previous ISOQOL experience.
Presentations at In-person ISOQOL Events:
Please specify below the year, event name, presentation type, and presentation title for past ISOQOL events.
Please format your answer as "Year, Event Name (Annual Conference, MWM Symposium, Education Course, etc.), Presentation Type (Oral, Poster, Oral Brief, Plenary, Workshop, etc.), Presentation Title" and separate presentations with a semicolon.
Service as a Volunteer at the Annual Conference

Please indicate your role as a volunteer at the Annual Conference and the applicable year(s) below.

	Year(s)
Mentor
Reviewer
Competition Judge
Scholarship Review Panel
Moderator
Symposium or Workshop Selection Subcommittee
Annual Conference Co-Chair
Other (please specify)

Service as an Organizer/Contributor for Online Education
Please specify below the year, event, your role, and presentation title (if applicable) for previous ISOQOL online educational events (including presentations).
Please format your answer as "Year, Event Type (Education Course, Webinar, Virtual Symposium, etc.), Role (Moderator, Chair, Instructor, Speaker, etc.), Event Title, Presentation Title" and separate your contributions with a semicolon.
Service as a Volunteer for QLR or JPRO
Please specify below the year, the journal, and your role for your previous service as a volunteer for QLR or JPRO.
Please format your answer as "Year(s), Journal (QLR or JPRO), Role (Reviewer, Associate Editor, Editor-in-Chief)" and separate your volunteer roles with a semicolon.
Service as a Committee or Task Force Volunteer
Please specify below the year, your role, and the Committee or Task Force for your previous service as a volunteer.
Please format your answer as "Year(s), Name of Volunteer Group, Role (Chair, Member, etc.)" and separate your roles with a semicolon.
Special Interest Group (SIG) Membership
Please specify below the year, your role, and the SIG memberships you have held.
Please format your answer as "SIG Name, Current Member (Yes/No), Year Joined, Leadership Position (Chair, Advisory Panel, Secretary/Treasurer, etc.), Years of Leadership Position" and separate memberships with a semicolon.
Contributions to SIG Projects/Activities

(Excluding Webinar, Virtual Symposia, and Annual Conference Symposia or Workshop Submissions)
Please indicate below the year, project type, project title, and the SIG associated with the project.
Please format your answer as "SIG Name, Type of Project, Year(s), Title of Project" and separate projects with a semicolon.
ISOQOL Awards
Please specify below the year you received the award and the award name.
Please format your answer as "Year Received, Award" and separate awards with a semicolon.
Other ISOQOL Activities
Please specify below any ISOQOL activities you participated in that have not been previously listed.

Section 2: Election Statement
In 500 words or less, please describe your motivation for becoming involved with ISOQOL. How does ISOQOL’s mission and vision relate to your work? *

0/500
In 500 words or less, please describe your qualifications and how your experiences will influence your ability to contribute as an ISOQOL Board Member. *

0/500
Review the 2024-2028 ISOQOL Strategic Plan. In 500 words or less, choose one strategy and describe an action ISOQOL could take to help achieve the related goal. *

0/500
View a PDF of the 2024-2028 Strategic Plan.
Closing Statement: Please provide any additional experiences, skills, or other information that the Nominations Committee should consider as part of your application to the Board.*

0/500

Section 3: Conflict of Interest Disclosure and Confidentiality
ISOQOL is committed to addressing any potential conflicts of interest that may arise among individuals involved in decision-making processes related to ISOQOL programs or activities. The integrity of these decisions is critical, and it is essential to avoid any actual, potential, or perceived conflicts of interest.

We acknowledge that various factors can influence an individual's judgment. This section is not meant to imply any assumptions of wrongdoing.

All members of the ISOQOL Board of Directors are required to continually disclose any significant financial interests or relationships with entities that have a commercial stake in ISOQOL activities, programs, or decisions.

Please note that, unless stated otherwise, disclosures should reflect current information or information from the past year.

In the space below, kindly outline any financial or other interests that may reasonably be perceived as conflicting with the interests of ISOQOL.

Employment
Any full- or part-time employment that may give rise to an actual, potential, or apparent conflict of interest must be disclosed.

Consultancies
Any consultant arrangements that may give rise to an actual, potential, or apparent conflict of interest must be disclosed if the consultation is current or proposed or if the consultation was performed, or payments or royalties were received for such consultation, within the prior two years.

Ownership Interests
Any ownership interests in an entity having a commercial interest in any program, activity, or matter under consideration by ISOQOL must be disclosed.

Honoraria and Funding
Any payments for specific speeches, seminar presentations, publications, appearances, and any receipt of funds for conducting research that may give rise to an actual, potential, or apparent conflict of interest must be disclosed.

Leadership Roles
Any leadership role past and present (e.g., as a board or committee member or advisor) in another healthcare organization must be disclosed.

Other
Any other significant financial interest in, or other relationship with, an entity having a commercial interest in any ISOQOL activities, programs, or decisions must be disclosed.
Please indicate below if any of the Conflicts of Interest listed above are relevant to your application.*

Section 4: File Uploads
Photo – .JPG, .JPEG, .PNG*

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CV or Biosketch – .DOC, .DOCX, .PDF*

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Should be Empty:

ISOQOL Board of Directors Application

Section 1: Candidate Application

Presentations at In-person ISOQOL Events:

Service as a Volunteer at the Annual Conference

Service as an Organizer/Contributor for Online Education

Service as a Volunteer for QLR or JPRO

Service as a Committee or Task Force Volunteer

Special Interest Group (SIG) Membership

Contributions to SIG Projects/Activities

ISOQOL Awards

Other ISOQOL Activities

Section 2: Election Statement

Section 3: Conflict of Interest Disclosure and Confidentiality

Section 4: File Uploads