FoMD Alumni Advisory Council Application

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Please complete this form to indicate your interest in applying for the FoMD Alumni Advisory Council. Please note we currently only have openings for applicants who live in Edmonton and area. If you live outside of Edmonton and wish to get involved, please contact fomdalum@ualberta.ca to learn about other opportunities.

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Freedom of Information and Protection of Privacy
The Office of Advancement collects information on behalf of the University of Alberta, its Faculties, and its Alumni Association, under the authority of Section 33(c) of the Alberta Freedom of Information and Protection of Privacy Act, for the purposes of administering alumni relations and development programs for the University of Alberta. Any information submitted by an individual to the Office of Advancement, including through an associated website or via email, may be used to update that individual’s record.

Information gathered in this form will be protected and used in compliance with Alberta’s Freedom of Information and Protection of Privacy Act. Individuals who submit information to the Office of Advancement acknowledge the above and the collection of personal information.

Questions concerning the collection, use or disposal of this information should be directed to the FOIP Liaison Officer, Office of Advancement, University of Alberta, 3-501 Enterprise Square, 10230 Jasper Avenue, Edmonton, AB, T5J 4P6, (780) 492-7400.

First Name *

Last Name *

Please confirm your affiliation with the Faculty of Medicine & Dentistry.

This application is only open to current students and alumni of our faculty. If you do not fall into either of these categories, we regret to inform you that you are not eligible to apply at this time. Thank you for your understanding.
*

I am an alumnus/a of the faculty.

I am a current student of the faculty.

Required

Please confirm your ability to attend meetings and events in Edmonton.

Being able to attend meetings and events in Edmonton is a requirement for this application. If you are unable to meet this requirement, we regret to inform you that you may not be eligible to apply at this time. Thank you for your understanding.

I currently reside in Edmonton or a surrounding area.

I do not live in Edmonton or a surrounding area, but I am able to travel to Edmonton for meetings and events.

We require applicants to be fully committed to the duties of the FoMD Alumni Advisory Council. Do you agree to the following statements?

I will serve the entirety of a two year term.

I will attend 5 evening meetings per year (half virtual, half in-person).

I will come to meetings prepared and informed about agenda items.

I will contribute to meetings by providing constructive suggestions and bringing forward new ideas.

Outside of meetings, I will spend 2-5 hours per month supporting alumni programs (e.g. volunteering at events, connecting with members of the community, developing programs, reviewing documents, etc.)

I will be actively involved in and informed about the U of A and Faculty of Medicine & Dentistry alumni programs.

I will represent the Faculty of Medicine & Dentistry with positivity and professionalism.

Current Occupation / Job Title

UAlberta Degree(s) & year(s)

Please list expected if you are a current student.

Degree(s) & year(s) from other educational institutions (if applicable)

Preferred phone number *

Preferred email address *

Please describe your interest in joining the FoMD Alumni Advisory Council. Why does this volunteer opportunity interest you and what do you hope to get out of it?

Describe any current or past involvement / engagement you've had at the U of A as a student or alumnus (e.g. volunteering, employment, special project or initiative, attending events, keeping informed, etc.).

Describe any current or past involvement you have in other community organizations or networks.

An equitable, diverse and inclusive council membership is important to us. Please describe how you would contribute to diversification of ideas and support equity and inclusion on the FoMD Alumni Advisory Council?

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