CND OHT Affiliate Membership - Expression of Interest

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The following expression of interest form must be completed and submitted no later than Friday, October 21, 2022 (*extended to October 28*). If you have any questions, please do not hesitate to contact Kristina Eliashevsky, CND OHT Transformation Lead, at kristinae@langs.org.

Name of Organization (Formal Legal Name) *

Address *

Name of Contact *

Phone Number *

Email Address *

Type of Organization *

Primary Care

Mental Health and Addictions

Community Support Services

Congregate Care

Specialty Services

Social or Housing Services

Other:

Please describe your organization's interest in becoming an Affiliate Member of the CND OHT. (Max 500 words) *

Please describe your organization's contributions and engagement in CND OHT work to date.

CND OHT Vision

We envision a community where people access seamless and integrated services to ensure the health and wellbeing of our diverse populations.

Please describe how your organization's strategic plan aligns with the work of the CND OHT and explain how becoming an Affiliate Member will assist the CND OHT in meeting its Vision. (Max 500 words) *

The CND OHT Membership Policy sets out several commitments for Affiliate Members. Please confirm your acceptance of the following conditions of Affiliate Membership:

Affiliate Membership is the entry level stage towards full membership in the CND OHT.

Affiliate members are entitled to regular information updates from the CND OHT, but will not participate in decision making activities.

Affiliate Members are entitled to participate in OHT education and training at their own cost.

Affiliate members are entitled and encouraged to engage in service coordination through the Steering and Operations Committees.

Affiliate Members may apply to become Members after one year.

Required

Thank You

The CND OHT Steering Committee and Joint Board Committee will be reviewing all expressions of interest in early November. We will be in touch with all applicants regarding next steps.

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