New Applicant Form

Please tell us about yourself and your interest in joining HDRN Canada’s Public Advisory Council (PAC) by answering the questions below. If you have any questions or would like to create a submission in a different format (e.g., video), please email Jannath Naveed at jannath.naveed@hdrn.ca. The deadline to submit an application is July 26, 2024. 

Please note: Everyone 18 years of age and over is welcome to apply, with one exception, outlined in our Terms of Reference).
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First name *
Last name *
Your email address
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I am a resident of Canada (required to be considered for membership on the PAC). *
City or town where you live (not your street address)
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Province or territory where you live
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First language *
Other languages you are fluent in *
Gender Identity *
Age range *
What interests you about health data and being part of the HDRN Canada Public Advisory Council?
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The Public Advisory Council supports the principles of inclusion, diversity, equity and accessibility (IDEA). Please tell us whatever you would like to about your background and the perspective(s) you would bring to the Public Advisory Council. You may choose to talk about your work, life experiences, upbringing, education or anything else.
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Do you have any experience as a public or patient partner or volunteer, for example, as a patient representative at a hospital or health charity, member of the board or advisory committee of a community group/organization, representative of an equity-deserving group or as an advisor under CIHR’s Strategy for Patient-Oriented Research (SPOR)? If yes, please describe your experience providing advice on issues or opportunities related to health data and/or health research.
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How did you hear about this opportunity? (Optional)
I understand that submitting this application and/or being interviewed does not guarantee a position on HDRN Canada’s Public Advisory Council.
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If I am not selected, I would like to be contacted in the future for other engagement opportunities (check one, both, or neither).
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