Chapter Election Reporting Form

The Importance of Chapter Reports to the CCFP Regional Office Following Elections

The submission of reports by chapters of the Caribbean College of Family Physicians (CCFP) to the Regional Office after elections is essential for several reasons. These reports not only ensure smooth organizational governance but also foster transparency, accountability, and strategic planning. Below are key reasons that highlight the significance of this practice:

1. Ensuring Organizational Continuity

A detailed report submitted after elections allows the Regional Office to stay informed about leadership changes and the chapter’s ongoing initiatives. This information is critical for maintaining continuity in the organization’s activities and ensuring that newly elected leaders can seamlessly take over responsibilities. By knowing the composition of the new executive team, the Regional Office can efficiently coordinate communications and allocate resources.

2. Promoting Transparency and Accountability

Reports provide a transparent record of the election process and its outcomes. This documentation is crucial in demonstrating adherence to the democratic principles and procedural guidelines of the CCFP. It reassures members that the elections were conducted fairly and that the results are legitimate. Transparency fosters trust among members and strengthens the credibility of the organization.

3. Facilitating Strategic Alignment

The submission of post-election reports helps the Regional Office align its strategic goals with the priorities and leadership focus of each chapter. These reports often highlight key plans, projects, and challenges faced by chapters, enabling the Regional Office to provide targeted support and guidance. This alignment ensures that the CCFP operates as a cohesive entity, working toward common objectives across the region.

4. Strengthening Communication Channels

Election reports establish a clear line of communication between chapters and the Regional Office. They serve as a formal update that keeps the Regional Office informed about leadership changes and any relevant updates. This regular exchange of information enhances collaboration, reduces misunderstandings, and fosters a stronger sense of unity within the organization.

5. Documenting Institutional Memory

Election reports contribute to the organization’s institutional memory by documenting leadership transitions, challenges, and achievements. These records are invaluable for future leaders who may need to reference past activities or decisions. A well-maintained archive of reports helps chapters learn from their history and build on previous successes.

6. Facilitating Regional Representation

The Regional Office relies on election reports to ensure that all chapters are adequately represented in regional discussions and decision-making processes. Knowledge of leadership structures allows the Regional Office to include the appropriate representatives in committees, conferences, and initiatives, fostering a sense of inclusivity and collaboration.

7. Supporting Leadership Development

Election reports often include profiles of new leaders, which can help the Regional Office identify individuals for mentorship, training, and further leadership opportunities. This contributes to building a strong and capable leadership pipeline within the organization.

8. Enhancing Compliance with Organizational Policies

The submission of reports is a reflection of chapters’ adherence to the CCFP’s governance policies. It underscores the importance of accountability at all levels of the organization and ensures that chapters are operating within the framework set by the Regional Office.

Conclusion

The practice of submitting reports to the CCFP Regional Office after chapter elections is not merely an administrative formality; it is a cornerstone of effective governance, accountability, and strategic growth. By promoting transparency, facilitating communication, and supporting alignment across the organization, these reports play a vital role in strengthening the CCFP’s ability to fulfill its mission of advancing family medicine throughout the Caribbean.

CHAPTER ELECTION REPORTING FORM

Instructions: Please complete and submit this form to the CCFP Regional Secretariat within two weeks after the election of a new Chapter Executive. Submit the completed form via email to familydoctorsrgional@gmail.com and president@caribgp.org and sroache113@gmail.com

Chapter Information

Name of Chapter

Country:

Date of Election:

Venue/Platform of Election:

New Executive Information

Please provide the full details of the newly elected executive:

Position

Name

Email Address

Phone Number

President

Name

Email Address

Phone Number

Vice-President

Name

Email Address

Phone Number

Secretary

Name

Email Address

Phone Number

Treasurer

Name

Email Address

Phone Number

Immediate Past President (if applicable)

Name

Email Address

Phone Number

Other (specify):

Name

Email Address

Phone Number

Executive Profiles

For each member of the new executive, please upload a brief profile and a recent photo image. Include the following in the profile:

Name

Position

Professional background

Key achievements or contributions to the CCFP

Goals for the term

Upload Instructions: Attach profiles and images as separate files (JPEG/PNG for photos and PDF/Word for profiles) when submitting this form.

Click or drag a file to this area to upload.

1. Election Process (Check the method used to conduct the election)

If additional methods are utilized, please specify here:

2. Number of Members Present:

3. Number of Votes Cast:

4. Quorum Achieved:

Plans for the New Term

1. Top Three Priorities of the New Executive:

2. Scheduled First Meeting Date:

Any additional remarks or notes on the election:

Verification

Name:

Position:

Signature:

Date:

For Official Use by the CCFP Regional Secretariat

1. Date Received:

2. Reviewed By:

3. Comments:

Membership Renewal

CCFP APPLICATION FOR MEMBERSHIP/SUBSRIPTION RENEWAL

I hereby make application to Renew my Membership to the Caribbean College of Family Physicians *

Renewal

Date of Renewal of Membership Application *

Name *

First

Middle

Last

Licensing Body Medical Council Rgn. #

Specialty *

Active Member up to 75 years (Renewal J$6,500) –

Sustaining Member

Direct Member up to 75 years (CCFP Regional)

Member fully retired from General Practice (Renewal Free)

Semi-Retired Member 76 years & over (renewal fee J$3500 or US$25)

Corporate Member (contact office)

Non Resident Member JM Chapter

Honorary Member ( Renewal Free)

Fellow (Contact Office)

Date of Birth *

Email *

Country/Chapter *

Year(s) being renewed *

please indicate the years being renewed

CCFP Membership Number

Please indicate your CCFP Membership #

Cell *

(please indicate cell and office)

Office

Please Upload Your Receipt

Click or drag a file to this area to upload.

Payment Agreement *

I’ve made the payment

Once payment is completed, please accept the payment agreement to continue.

Subscription Renewal

Invoice#

CARIBBEAN COLLEGE OF FAMILY PHYSICIANS Cash/ Cheque Payment Form

To: The Caribbean College of Family Physicians (CCFP)

Name

Tel

Email Address

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date

Cheque No

Bank

CCFP Membership Number:

Territory

Kindly renew my Membership to CCFP, I enclosed a cheque/cash/Card in the sum of:

Cash/ Credit Card/Debit Card

Membership Application

MEDICAL REGISTRATION NUMBER *

DATE *

(M/D/Y)

LAST NAME *

FIRST NAME *

MIDDLE NAME *

DATE OF BIRTH *

MAILING ADDRESS *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

EMAIL ADDRESS *

PHONE *

WORK *

HOME

FAX

PAGER

CELL

DEGREES, DIPLOMAS ETC.

Qualifications *

Institution *

Year *

CURRENT POSITION/ OCCUPATION *

INVOLVEMENT IN FAMILY PRACTICE: *

PART TIME
FULL TIME

INTERESTS

Medical Interests *

Non-Medical Interests *

MEMBERSHIP FEE US$100.00 *

NAME OF REFERRING CCFP MEMBER: *

REFEREE INFORMATION (NOT APPLICABLE TO FOUNDING MEMBERS)

ADDRESS *

PHONE *

YOUR CV’s *

Click or drag a file to this area to upload.

(A copy of your CV’s would be appreciated; also an indication of your willingness to assist with the development of the College and in what aspect.) Copy to 19A Windsor Avenue, Kingston 5, Jamaica, West Indies

Your Degrees/Certificate *

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Your Practicing Certificate *

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Your Passport size Photograph *

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Please Upload Your Receipt *

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Payment Agreement *

I’ve made the payment

Once payment is completed, please accept the payment agreement to continue.

Member Accreditation Form

CARIBBEAN COLLEGE OF FAMILY PHYSICIANS MEMBER ACCREDITATION APPLICATION FORM

This form is for application for Accreditation to the Caribbean College of Family Physicians. You will be required to deliver copies of your CME Certificates to the CCFP Secretariat for final  verification.

I confirm that I have completed 50 hours of CME activities each year or a total of 150 hours for the Triennium (3 years) *

Name *

First

Last

Confirmation of Full Name *

First

Last

Email *

Telephone Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Specialty *

Country/Island *

Years in practice *

Number of years accreditation being applied for

Please upload your CME Log Sheet here, or you can send to the CCFP Secretariat by email, then deliver to the CCFP copies of your CME Certificates to the CCFP Secretariat

Click or drag a file to this area to upload.

I confirm that the information and records I have provided are correct and accurate to the best of my knowledge (E&OE)

Option 1

CME Log Sheet

CARIBBEAN COLLEGE OF FAMILY PHYSICIANS CME HOURS REGISTER

YEARS UNDER REVIEW

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Date/Year

CME ACTIVITY

EVENT SPONSOR/HOST

VENUE

CREDIT HOURS

Annual Membership Declaration Form

As we approach the end of the year, it is time for our chapters across the Caribbean to declare their annual membership to the College.

We understand the crucial role that each chapter plays in advancing the field of family medicine in the region, and we greatly appreciate your ongoing commitment and dedication. Your chapter’s participation is essential in fostering collaboration, sharing knowledge, and enhancing the overall impact of the Caribbean College of Family Physicians.

To complete the annual membership declaration process, we kindly request that you provide the information as stated on the form for your chapter:

Please submit the information by January 31^st, as this will enable us to compile a comprehensive report on the collective achievements and contributions of all our chapters in the Caribbean.

Your cooperation is invaluable in strengthening the network of family physicians in the region and advancing the goals of the Caribbean College of Family Physicians. If you have any questions or require assistance during this process, feel free to reach out to us at familydoctorsregional@gmail.com

We appreciate your commitment to the Caribbean College of Family Physicians (CCFP) and kindly request you to complete the Annual Membership Declaration Form for your regional chapter

Chapter Name: *

Chapter Address: *

Chapter Email: *

Chapter President's Name: *

President's Email: *

Chapter Secretary's Name: *

Secretary's Email: *

Total Membership Count: *

Total Paid-Up Members: *

Annual Renewal Dues per member: *

New Dues (amount) per member: *

New Members (Number): *

Upload Membership Register: *

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Please upload the membership register document containing the following details for each member: Full Name, Email, Specialty, Telephone Contact.

Upload Chapter Executives: *

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President, Vice President, Secretary, Treasurer, and other relevant positions. Please upload a document containing their full names and positions.

Please upload Chapter Activities Report *

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• A brief summary of the activities and events organized by your chapter throughout the year.

Please upload Financial Statement: (Optional)

• An overview of your chapter’s financial status, including income and expenses related to College activities.(Optional)

Feedback and Suggestions:

• Any feedback or suggestions that your chapter may have regarding the College’s initiatives, programs, or areas for improvement.

Thank you for your continued support, and for your submission. We will forward your Cess Invoice as soon as we receive your declaration. Please be reminded that CESS is charged on members in good standing for the period the declaration is submitted.