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 or one of its working groups. All applicants will be contacted.

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

Current Occupation / Job Title

Degree(s) & year(s)

Preferred phone number

Preferred email address

Preferred mailing address

If you were on the Alumni Advisory Council, what would you like to accomplish or what ideas do you have for alumni engagement at the Faculty of Medicine & Dentistry?

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 could contribute to diversification of ideas and support equity and inclusion on the FoMD Alumni Advisory Council or its working groups?

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

I will attend 5 evening meetings per year, to the best of my ability.

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.

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