Council Elections - Conflict of Interest Declarations for Nominees

In accordance with section 16 of the bylaws of the College of Naturopaths of Ontario, you are required to disclose whether you, or one of your family members (patent, spouse, child or sibling) have any affiliations, interests or relationships that may impact or be perceived to impact your decisions.

 
 

About You

Please provide the following information about you and the positions you hold with the College.

 
 
 

Please enter the tracking number provided for your on-line expression of interest form submission. It will start with NCF2022 - .

 

Please enter your four digit registration number with the College of Naturopaths of Ontario.

 

As this is part of the election process, this declaration is used solely for the purposes of determining your eligibility for election.

 
 

About Conflicts of Interest

A conflict of interest arises where you have a personal or professional interest which conflicts, might conflict or may be perceived to conflict with the interests of the College of Naturopaths of Ontario, including a conflict with your duties as a member of the Council, its Committees or as an employee or a person who is under contract with the College. A conflict of interest could arise in relation to personal matters including: • directorships or other employment; • interests in business enterprises or professional practices; • share ownership; • beneficial interests in trusts; • existing professional or personal associations; • professional associations or relationships with other organizations; and • personal associations with other groups or organizations, or family relationships. Any obligation, commitment, relationship or interest that could conflict or may be perceived to affect your judgment or the discharge of your duties to the College must be declared.

 

Part 1 - Disclosure of Appointed or Elected Offices Held

 

Do you have a direct or indirect conflict with your duty as a member of one or more committees because you or a member of your family hold appointed or elected offices?

 

Part 2 - Disclosure of Ownership or Possession of Outside Interests

 

Do you have a direct or indirect conflict with your duty as a member of one or more committees because you or a member of your family own or possess, directly or indirectly, interests outside of the College?

 

Part 3 - Disclosure of Financial Compensation Received

 

Do you have a direct or indirect conflict with your duty as a member of one or more committees because you or a member of your family receive financial compensation (either for services performed, as an owner or part owner, trustee or employee) from an outside organization?

 

Part 4 - Disclosure of Relationships with External Organizations

 

Other than those disclosed above and in any follow up email to ceo@collegeofnaturopaths.on.ca, do you have any relationships or interests that could compromise or be perceived to compromise, your ability to exercise judgement or decision-making independently and objectively and with a view to the public interest and best interests of the College?

 
 

Declarations and Signature

Please complete the following declarations and signature fields.

 

Declaration


I hereby declare that the information that I have provided on this form and in any follow up email to ceo@collegeofnaturopaths.on.ca is complete and accurate to the best of my abilities.

 

Signature


By checking the box below, you are affixing a signature to this form and indicating that this form and the information contained herein is bound directly to you.

 

Submission Copy

Below is a check box to receive a copy of your submission. It is highly recommended that you check this box and enter your e-mail address for a second time. This will enable the on-line system to send you a copy of the information that you have provided to the College.