Board application form Name *FirstLastEmail *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? *YesNoDo you support the current Standards of Care (SOC8) and evidence-based practice?YesNoOtherwiseEPATH 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? *YesNoIf 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)? *YesNoMaybeAre you able to dedicate approximately 4 hours per month to board duties? *YesNoMaybeAre you able to commit to a 4-year term on the EPATH Board of Directors (At-large Directors)? *YesNoMaybeDo you have any conflicts of interest to declare that may impact your ability to support EPATH's mission? *YesNoIf 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). *Sign-up to our newsletter?Website / URLNameSubmit
