UFA Cooperative Limited 2012 Director Nomination Form - UFA.com

UFA Cooperative Limited
2012 Director Nomination Form
Candidate Self-Assessment & Statement of Interest
Issues of business governance have never been more important. Canadian
organizations, boards, executives and other stakeholders have been working to
strengthen governance practices following the corporate scandals of recent years. As a
result, the role of the board director is more demanding, complex and onerous than it
has been in the past. Because society expects and demands more from directors, the
role has become more professional.
Directors of UFA are expected to bring to the board the broadest possible knowledge
and depth of experience from their chosen business or profession.
Directors should demonstrate the ability to deal with business, financial and social issues
within the co-operative environment and context. In other words, we require a capacity
to provide additional strength, diversity of views and up-to-date perceptions to the board
and its deliberations.
As director should possess integrity, be willing to articulate his or her views frankly, be
able to work productively with others and have the ability and willingness to commit the
time and effort required.
Directors should be fully informed about their responsibilities and liabilities as a director
prior to a commitment to serve.
UFA director are required to meet the following minimum eligibility requirements:
• Be 18 years of age or older.
• Be a Canadian citizen or a person lawfully admitted to Canada for permanent
residency who is ordinarily a resident in Canada.
• Be a member of UFA and eligible to vote.
• Be a patron of the Association in the previous year.
• Is not an employee or agent of and does not hold any office or profit with UFA.
• Is not a member of the Canadian House of Commons or any Provincial
Legislature?
• Holds no material interest in any agent of UFA or business in competition with
UFA.
• Has not been convicted of any offence under the Criminal Code of Canada for
which no pardon has been issued.
Please let us know how you heard about our director call for nominations?
Newspaper Web site Store/agency Other
Advertising

Candidates are asked to self-assess their qualifications, skills and experience in
reference to the 2011 director attribute, background and skill outline. Below, please set
out in the space provided a summary of each category.
The deadline for receipt of director nomination forms is 4:00 p.m. October 31, 2011.
Please forward completed forms to:
UFA Cooperative Ltd.
Attention: Lori Connolly
Suite 700, 4838 Richard Road SW
Calgary, AB T3E 6L1
By fax at 403-570-4007 or by email at lori.connolly@ufa.com
Interviews for eligible candidates will be held in Calgary on November 7, 2011.
Print Name
City
Phone
Date
Postal Code
Cell
PROFESSIONAL EXPERIENCE
(e.g., major positions held, career highlights, awards for career/business, education)
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GOVERNANCE EXPERIENCE
(e.g., corporate, community and not-for-profit boards the candidate sits on)
COMMUNITY INVOLVEMENT
(e.g., volunteer positions, associations, etc.)
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PERSONAL STATEMENT AND SUMMARY
(Provide any further information not yet covered and/or a general summary of how your
experience, perspective or expertise would contribute to UFA’s board of directors)
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QUESTIONS
Why are you interested in joining the UFA board of directors?
Why would you be an effective board member for UFA?
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References
Please provide three professional or personal references
Name Occupation Phone
Name Occupation Phone
Name Occupation Phone
Before signing, be sure your application is filled out COMPLETELY and that you have
read and understood the following declaration:
By signing and submitting this application form, I acknowledge that:
1. All statements made in application are true and accurate.
2. Any misstatements of material facts herein may cause forfeiture of my position as
a director with UFA.
Print Name
Date
Signature
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