Willingness to Serve Application for Patient/Family Representative Submission Instructions To qualify for the term which begins in November 2021 and ends in October 2023 the nominee must be a patient, parent or caregiver and be actively involved in, or knowledgeable about, neurodevelopmental issues for children and adults with CHD. All volunteer leadership serving on any committee, or in any office of CNOC, will be required to complete a Conflict of Interest Disclosure. The Steering Committee meets by conference call at least monthly, and more frequently as needed. Willingness to Serve applications and attachments must be submitted no later than November 30 to earn recognition on the ballot. In an effort to assist the Steering Committee in determining their appointment, all candidates must submit a photograph of themselves and a biographical statement of 250 words or fewer to include: Interest in this role Relevant Job or volunteer experience Goals Patient/Family Representative To review CNOC's Bylaws for more information, and complete position descriptions, click here. Questions? Liz Blumenfeld Jessica Cowin First Name: Last Name: Credentials: Address: City: State: Zip Code: Email Address: Phone: Biographical Statement (250 words or fewer): Word Count: Photograph of yourself(file size must be no larger than 3MB. Valid file types are: jpg gif png) Photograph may take a minute or two to upload depending on file size.