BOARD MEMBERSHIP REGISTRATION FORM

COMPANY INFORMATION

Company Name *
   
Street Address *
   
Suite Number *
City *
   
Province/State *
   
Postal code/Zip code *
   
Country *
   
Organization Size by Gross Revenue *
   
Type of Company *
   
Industry Type *
   
Month of AGM/APM or Appointment Date of Directors *
   

MEMBER INFORMATION


The Board Membership allows for up to 15 members including senior executives (I.E. CEO, CFO, Corporate Secretary, etc.).

Fees for additional members are:

  • $200 per person for For-Profit and Commercial Crown boards
  • $100 per person for Not-For-Profit boards

Member Roster

We require the following information for each of your members:

  • Member’s First and Last Names
  • Preferred Title (Job title/Board title/Not applicable)
  • Preferred Mailing address (corresponding to Preferred title) – please indicate if work or home
  • Email address
  • Telephone number


Please CLICK HERE for a SAMPLE Roster.

Upload your board roster

   

BOARD MEMBERSHIP ADMINISTRATOR

This is the individual from your organization who manages the membership roster, receives invoices and provides general administrative support for the Board Membership.

Prefix *
   
Name *
   
Current Title / Position *
   
Email *
   
Telephone (preferred) *
   
Ext. *


BOARD MEMBER ENGAGEMENT CONTACT

This board member is the person with whom ICD can engage with to provide tools and resources with an aim of improving the organization’s board governance practices.

Prefix *
   
Name *
   
Current Title / Position *
   
Email *
   
Telephone (preferred) *
   
Ext. *


GRANT OF RIGHT:

The Authorized Signatory agrees they hereby grant the Institute of Corporate Directors (ICD) permission to use the Board member Company’s name in any and all of ICD’s publications and public relations activities, including website and advertisements, without payment or any other consideration. In addition, the Company waives the right to inspect or approve the finished product, including written or electronic copy, wherein the Company’s name appears. Additionally, the Company waives any right to royalties or other compensation arising or related to the use of the name and board information. The company hereby holds harmless and releases and forever discharges the ICD from all claims, demands, and causes of action which the Company , its representatives, executors, administrators, or any other person acting on its behalf by reason of this authorization.

Do you agree?


   

TERMS & CONDITIONS

In order to become an ICD member, all applicants must read and agree to adhere to the ICD Code of Conduct. Once the board membership has been processed all individuals associated with the board membership will be sent and asked to agree to the ICD Code of Conduct. Membership with the Institute of Corporate Directors is paid annually, is non-transferable and non-refundable.

Thank you for your application and commitment to good governance. Our membership engagement team will contact you to finalize your application.

By clicking SUBMIT, you acknowledge that you are in agreement with the above Terms and Conditions.