Board application form

Name *
First
Last
Email *
Country of residence *
Specialty / Designation / Affiliation *
Degree *
Please indicate # of years as a Full Member of WPATH *
Do you support the mission of EPATH? To promote evidence-based care, education, research, advocacy, public policy and respect in transgender health? *
Yes
No
Do you support the current Standards of Care (SOC8) and evidence-based practice?
Yes
No
Otherwise
EPATH Board of Directors shall act in accordance with the ethical standards set by professional specialty boards or other professional societies where they hold certification or membership. Are you currently under disciplinary action by your college or professional society? *
Yes
No
If you answered "Yes" to the question above, please provide a summary of the allegation.
Please list all your current memberships of any professional organisation.
Describe your previous board experience or your understanding of the roles and responsibilities of board members. *
Are you able to attend meetings regularly (both online and/or in-person)? *
Yes
No
Maybe
Are you able to dedicate approximately 4 hours per month to board duties? *
Yes
No
Maybe
Are you able to commit to a 4-year term on the EPATH Board of Directors (At-large Directors)? *
Yes
No
Maybe
Do you have any conflicts of interest to declare that may impact your ability to support EPATH's mission? *
Yes
No
If you answered Yes or Maybe to the question above, please explain below.
Please include a personal statement outlining your background and vision for EPATH (max 500 words). *
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