ONCOLOGY NURSING CERTIFICATION CORPORATION

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ONCOLOGY NURSING CERTIFICATION CORPORATION Powered By Docstoc
					                     ONCOLOGY
                     NURSING
                     CERTIFICATION
                     CORPORATION
                                                               125 Enterprise Drive Pittsburgh, PA 15275-1214

                                                                  Toll Free: 877-769-ONCC Fax: 412-859-6168
                                                                E-mail: oncc@oncc.org Web Site: www.oncc.org




Dear Candidate,

Thank you for your interest in a nomination packet for the Oncology Nursing Certification Corporation Board of
Directors. The election will be held in November–December 2011.

The entire constituency of oncology certified nurses (OCN®, AOCN®, AOCNS®, AOCNP®, CPON®, CBCN®, and
CPHON®) is eligible to vote for:

   One position, which is open to nurses who hold OCN® certification. This position is for a 3-year term
    beginning in June 2012.

Criteria for nominations include the following:

        1.      A nominee shall exemplify integrity, sensitivity, good communication and oral presentation
                skills, leadership and planning skills, analytical ability, decision-making ability, strategic planning
                experience, and the ability to organize and monitor work.

        2.      A nominee must:
                a.     meet the qualifications and be able to fulfill the responsibilities identified in the Board
                       of Directors Policies (sections 1.0-1.13 of the ONCC policy manual). The pertinent
                       sections are enclosed.
                b.     electronically submit the completed nomination packet and mail or fax the forms
                       requiring a signature, to the ONCC office for receipt by the July 25, 2011 deadline.
                       References may be sent by first class mail or emailed, but also must be received by July
                       25, 2011.

        3.      Nominations must be submitted by registered nurses with current licensure. Self-nominations
                will be accepted and are encouraged.

        4.      Nominees will be notified whether they have been slated for the ballot by mid September 2011.

The successful candidate will take office on June 1, 2012 and will be expected to attend three Board meetings
per year, at least one of which will be held at the ONCC Headquarters in Pittsburgh. The estimated annual time
commitment for ONCC Board members for meeting attendance is 12 days, which includes weekdays and
weekends. All expenses directly related to meeting attendance will be reimbursed by ONCC.

All ONCC Board members are expected to participate on Board committees, chair committees, and run for
positions on the Executive Committee when they are eligible. The Executive Committee consists of the ONCC
President, Vice President, and Secretary/Treasurer. Board members are eligible for these offices after one year
of service on the Board and all Board members should be prepared to hold an office sometime during their

                                                                                                                      1
term.

The Nomination Packet includes information about the policies, duties and responsibilities that we hope will
enable you to make an informed decision about seeking a position on the Oncology Nursing Certification
Corporation Board. It also includes information we need from you to assist the Nominating Committee in
selecting qualified candidates. The following items comprise the Nomination Packet:

1.      Nomination form.

2.      Antitrust policy, Conflict of Interest Policy, Security Requirement and Campaigning Policy forms. Please
        sign, copy and return the Conflict of Interest, Security Requirement, and Campaigning Policy forms, by
        mail or fax to ONCC.

3.      Sections 1.0-1.13 of the ONCC Policy Manual, which includes the expectations, requirements,
        restrictions, rules, and qualifications of each Board member, and an ONCC organizational chart.

4.      ONCC Vision, Mission and Values Statements. The nominee must submit via email a statement of no
        more than 250 words on the ONCC Mission Statement Form describing how she/he would
        fulfill/advance the Mission of the Oncology Nursing Certification Corporation as a Board member. If you
        are slated, your statement will be posted on the ONCC website for voters to review.

5.      Reference Forms. Two references must be submitted. Reference forms are available on the ONCC web
        site at www.oncc.org. These forms must be emailed to onccnominations@oncc.org prior to the July 25,
        2011. You are responsible for assuring the references are submitted.


A current Curriculum Vitae or Resume also must be submitted with the nomination.

Following the deadline for the receipt of nomination forms, the Nominating Committee will review all forms
and, using an objective rating system, will determine the candidates who will appear on the ballot. Nominees
will be notified as to whether or not they will be slated on the ballot by mid September 2011. If slated, you will
be asked to provide a photograph suitable for publication on the election ballot, on the ONCC web site, and in
other ONCC publicity materials.

Please note that if you are elected to the ONCC Board of Directors, by policy, you will not be permitted to take
the OCN®, AOCNS®, AOCNP®, CPHON® or CBCN® Examinations during your term on the board, and for two years
thereafter. Therefore, you must renew your OCN®, AOCN®, AOCNS®, AOCNP®, CPON®, CPHON®, or CBCN®
certification during and for two years after your board term, using the Oncology Nursing Certification Points
Renewal Option (ONC-PRO).

All nominating forms may be downloaded through the ONCC website at www.oncc.org.

Please return your completed nomination forms to onccnominations@oncc.org no later than July 25, 2011.
Return all forms requiring a signature via fax at (412) 859-6168 or by mail to:

Oncology Nursing Certification Corporation
125 Enterprise Drive
Pittsburgh, PA 15275

**ELECTRONIC SUBMISSIONS ARE REQUIRED**




                                                                                                                     2
Assure receipt of your written references to onccnominations@oncc.org by July 25, 2011.

Please review the Nomination Packet carefully to understand the steps necessary to be slated on the ballot. If
you require assistance, please contact me or any of the other Nominating Committee members via email or
phone. Thanks for your interest in serving on the ONCC Board of Directors.

Sincerely yours,

Bertie Ford, RN, MS, OCN®
Chair, 2009-2011 ONCC Nominating Committee

cc:     Cynthia Miller Murphy, MSN, RN, CAE, Executive Director


enclosures




                                                                                                                 3
                              ONCOLOGY NURSING CERTIFICATION CORPORATION
                                 BOARD OF DIRECTORS NOMINATION FORM

This form may be downloaded from the ONCC website at www.oncc.org, completed and emailed to
onccnominations@ons.org.

   I.   Name
        Professional Title
        Degree, Credential
        Preferred Mailing Address
        Telephone Number
        Fax Number
        Email Address

            OCN®        Date Certification Initially Earned                Expiration Date

            AOCN®       Date Certification Initially Earned                Expiration Date

            AOCNS®      Date Certification Initially Earned                Expiration Date

            AOCNP®      Date Certification Initially Earned                Expiration Date

            CPON®       Date Certification Initially Earned                Expiration Date

            CBCN®       Date Certification Initially Earned                Expiration Date

            CPHON®      Date Certification Initially Earned                Expiration Date


        A. Please list your experience serving on boards, committees, councils, teams, or other organizational
            groups. Include your experience in local and/or national organizations as well as service on teams or
            committees at your work place. Describe your specific involvement (e.g. member chair,
            coordinator) and provide the dates of your service. (If more space is required, please attach
            additional paper.)

        Group Name                  Organization               Specific Involvement          Dates Served
        Example:                    Example:                   Example:                      Example:
        Nominating Committee        ONCC                       Member                        2003-2006




        B. Please list your experience in local or national service relating to credentialing and/or certification
            (e.g. item-writing for a licensing or certification examination, passing score task force member,
            ONCC advocate, planning or teaching certification review course). Provide the dates of your service.
            (If more space is required, please attach additional paper.)




                                                                                                                     4
          Group Name             Organization                                      Specific Involvement   Dates Served
          Example:               Example:                                          Example:               Example:
          Item Writing Committee National Council State                            Wrote NCLEX items      2002
                                 Boards




II.       References

          Please list one person with whom you have worked professionally and one with whom you have worked
          on a committee or other type of association/organizational work. Each person must complete and
          submit a reference form to ONCC by July 25, 2011.

          1.         Name
                     Title
                     Address
                     Telephone Number
          2.         Name
                     Title
                     Address
                     Telephone Number


III.      Please email your Curriculum Vitae or Resume to: onccnominations@ons.org.

IV.       Please email your statement describing how you would fulfill/advance the mission of ONCC as a Board
          member to: onccnominations@oncc.org.

V.        Please submit signed Conflict of Interest, Security Requirement, and Campaign Policy forms by mail or
          fax.

VI.       Statements of Consent
          A.     I hereby consent to have my name submitted to the Nominating Committee of the Oncology
                 Nursing Certification Corporation.

          B.         I further consent to the Nominating Committee interviewing the above two references to
                     validate my professional qualifications for this position.

          C.         I am aware of, believe I am qualified for, and, if elected, am willing to accept the responsibilities
                     of this position.

Email to onccnominations@oncc.org

ONCC 09/90, 08/91, 08/92, 07/98, 08/99, 6/00, 2/01, 5/02, 01/04, 4/05, 8/05, 4/06, 5/09, 4/10, 5/11




                                                                                                                         5
                                      Oncology Nursing Certification Corporation
                                                Mission Statement

This form may be downloaded from the ONCC website at www.oncc.org. Please return the completed form via email to
onccnominations@oncc.org.


“To promote excellence in patient care and professional practice by validating specialized knowledge in oncology nursing
and related specialties.”

In 250 words or less, describe how you would fulfill/advance the mission of the ONCC as an ONCC Board member.




Name                                                                                  Date
                   Oncology Nursing Certification Corporation

                                                                                     Anti-Trust Policy
                                                                                     29.00 Page 1 of 1



The ONCC Board of Directors, committee members, employees, and other people acting on behalf of ONCC are committed
to an undeviating policy to comply with all applicable antitrust laws. In an effort to control activities of ONCC that could
violate this ONCC policy, the following procedure shall be implemented

        1.      No one shall communicate, explicitly or implicitly, in ONCC's name such as in speeches, articles, testimony,
                or letters without the prior approval of the ONCC president, deputy executive director, or executive
                director.

        2.      ONCC’s legal counsel should review any matter of communication that could raise a question of
                anticompetitiveness or any other antitrust question.

This antitrust policy shall be distributed to all members of ONCC's Board of Directors, committee members, employees, and
other people acting on ONCC's behalf.




5/99




                                               ONCC Policy Manual
                                Oncology Nursing Certification Corporation
                               ONCC Policy Manual Conflict of Interest 28.00
                                               Page 1 of 9
    ONCOLOGY NURSING SOCIETY (ONS), ONS FOUNDATION, ONCOLOGY NURSING CERTIFICATION CORPORATION
                                         (ONCC), AND ONSEDGE
                                FINANCIAL CONFLICT OF INTEREST POLICY

FINANCIAL CONFLICT OF INTEREST POLICY:
The Boards of Directors and Trustees (“Boards”) of the Oncology Nursing Society (ONS), the ONS Foundation, the
Oncology Nursing Certification Corporation (ONCC), and ONSEdge (together, “Affiliated Organizations”) have adopted
the following Conflict of Interest Policy to meet the requirements of the new Internal Revenue Service (IRS) Form 990.

A) Purpose.
The purpose of this Conflict of Interest Policy (the “Policy”) is to protect the interests of the Affiliated Organizations in
connection with any transaction or arrangement that might benefit the private interests of any Applicable Person, as
defined below. An identical policy has been adopted by the Boards of each of the Affiliated Organizations. This Policy
provides a systematic mechanism for disclosing and evaluating potential and actual conflicts. There is a separate
procedure, which the Board of Directors or a committee thereof shall follow in considering any transaction or
arrangement where a conflict may exist.

B) Persons Applicable by the Policy.
This policy applies to all “Applicable Persons,” defined as follows: any current Affiliated Organization Director, Officer,
member of any committee of the Boards, key employees as defined by the IRS or senior employee as identified by the
CEO or President of ONS. All Applicable Persons with ongoing relationships with Affiliated Organization shall complete
an Annual Financial Disclosure Form. Applicable Persons for the current year are included on the list attached as the
Annual Financial Disclosure Form.

C) Duties of Applicable Persons.
        a. Duty of Care. Every Applicable Person shall perform his or her duties for Affiliated Organizations in good faith
        and with the degree of care that an ordinarily prudent person would exercise under similar circumstances.
        b. Duty of Loyalty. Every Applicable Person must act with loyalty to the Affiliated Organizations, meaning that no
        Applicable Person may use his or her position with Affiliated Organizations to make personal profit or gain other
        personal advantage. No Applicable Person may personally take advantage of a business opportunity that is
        offered to Affiliated Organizations unless the Board of Directors or committee thereof determines (after full
        disclosure and a disinterested and informed evaluation) not to pursue that opportunity.
        c. Conflicts of Interest. No Applicable Person may engage in any transaction or arrangement with other
        organizations that involve a conflict of interest with respect to Affiliated Organizations, except in compliance
        with this Policy. Applicable Persons should avoid both actual conflicts and the appearance of conflicts of interest.
        Every Applicable Person shall:
                 (i) Disclose all actual and potential conflicts as set out below at Section 5; and
                 (ii) Recuse himself/herself from voting on any transaction or arrangement in which he/she has a
                 potential or actual conflict of interest, and shall not be present when any such vote is taken.
Conflict of Interest
28.00 Page 2 of 9

D) Conflict of Interest.
        a. Potential Conflict. An Applicable Person may have a conflict of interest with respect to a transaction or
        arrangement whenever he or she, or any member of his or her family (including parents, grandparents, spouses,
        siblings, children, grandchildren, great-grandchildren, and the spouses of such persons):
                 (i) Receives financial benefits directly or indirectly from Affiliated Organizations;
                 (ii) Has or anticipates having a financial arrangement with any entity or individual that either has
                 business transaction with Affiliated Organizations or competes with Affiliated Organizations;
                 (iii) Has or anticipates having any ownership interest, investment interest, or serves or anticipates
                 serving as a director or officer of, any entity that either transacts business with Affiliated Organizations
                 or competes with Affiliated Organizations; or
                 (iv) Has accepted any gift, entertainment, or other favor where such acceptance might create the
                 appearance of influence on the Applicable Person (other than gifts of nominal value, which are clearly
                 tokens of respect and friendship unrelated to any particular transaction).
                  (v) Serves as a director, officer, or employee of any specific organization identified by Affiliated
                 Organizations as a competitor.
        b. No Conflict. An Applicable Person does not have a conflict of interest if the Applicable Person owns securities
        of a publicly traded company with which Affiliated Organizations has a transaction or arrangement if:
                 (i) Such securities are less than 5% of the outstanding securities of the publicly traded company; and
                 (ii) Their fair market value is less than 5% of the Applicable Person’s annual gross income.

E) Disclosure and Evaluation of Conflicts.
         a. Disclosure. Each Applicable Person shall promptly and fully disclose all material facts of every actual or
         potential conflict of interest:
                  (i) Existing at the time when he/she becomes an Applicable Person;
                  (ii) That arises while he/she is an Applicable Person, at the time such actual or potential conflict arises;
                  and
                  (iii) Annually through the annual Disclosure Questionnaire.
                  (iv) Within 60 days of the occurrence of any changes. The Applicable person shall update the disclosure
                  form online.

F) Acting on Conflict of Interest Transactions.
        a. Formal Approval. Affiliated Organizations may approve a transaction or arrangement in which an Applicable
        Person has a conflict of interest if:
                 (i) The Applicable Person has disclosed the conflict of interest in accordance with this Policy:
                 (ii) AA simple majority of Directors who have no interest in the transaction or arrangement approve the
                 transaction or arrangement at a board or committee meeting after determining, in good faith and after
                 reasonable investigation, that the transaction or arrangement is fair and reasonable to Affiliated
                 Organizations and is in the best interest of Affiliated Organizations;
                 (iii) Any Applicable Person who has an actual or potential conflict with respect to the transaction or
                 arrangement does not participate in and is not present for the vote regarding any such transaction or
                 arrangement (provided, however, that any such Applicable Person may appear at a meeting to answer
                 questions concerning the transaction or arrangement); and
                 (iv) The Boards rely upon appropriate comparability data, such as an independent appraisal or an
                 independent compensation study, in reaching its determination as to the fairness and reasonableness of
                 the transaction or arrangement to Affiliated Organizations.
        b. Transaction Fair to Affiliated Organizations. It shall not be a violation of this Policy if all the requirements for
        formal approval, outlined above, are not satisfied, so long as the transaction or arrangement is in fact fair to
        Affiliated Organizations, furthers its tax-exempt purposes, and does not result in inurement, or impermissible
        private benefit.
Conflict of Interest
28.00 Page 3 of 9

G) Records of Proceedings.
       a. Content of Minutes. The minutes of the Boards or any committee of the board for any meetings described
       above shall contain:
                (i) The names of the persons who disclosed an actual or potential conflict of interest or otherwise were
                found to have a conflict of interest, and the nature of the conflict of interest; and
                (ii) The names of the persons who were present for discussions and votes relating to the transaction or
                arrangement, the content of the discussion, including any alternatives to the proposed transaction or
                arrangement considered and the appropriate comparability data relied upon, and a record of any votes
                taken.
       b.       Timing. The minutes of any meeting described above shall be prepared by the later of the next
                succeeding meeting of the Boards or committee, or 60 days after the final action on the matter is taken
                by the Boards or committee.

H) Enforcement
        a. Each Applicable Person shall sign a statement acknowledging that he or she has received a copy of this Policy,
        has read and understands it, and agrees to comply with it. If the Boards has reasonable cause to believe that an
        Applicable Person has failed to comply with this Policy, the Board may counsel the Applicable Person regarding
        such failure and, if the issue is not resolved to the Board’s satisfaction, may consider additional corrective action
        as appropriate.

Approved By ONS Board of Directors; 4/21/09
Conflict of Interest
28.00 Page 4 of 9

ANNUAL FINANCIAL DISCLOSURE FORM:

I. REPORTING OBLIGATIONS

A. Purpose of Form. The Boards of Directors and Trustees (“Boards”) of the Oncology Nursing Society (ONS), the ONS
Foundation, the Oncology Nursing Certification Corporation (ONCC), and ONSEdge (together, “Affiliated Organizations”)
have adopted this Applicable Person Financial Disclosure Form (the "Form") as the primary means to track information
related to actual or potential conflicts of interest involving Affiliated Organizations and to comply with the Affiliated
Organizations reporting obligations, in accordance with the Affiliated Organizations Conflict of Interest Policy.

B. Applicability. This Questionnaire is to be completed annually, within 30 days of receipt by any Applicable Person. For
purposes of this Form, an Applicable Person is defined as any person who is a current Affiliated Organizations officer,
trustee, or member of a committee of the Boards, as well as any person designated by ONS’s CEO or President, or the
ONS Foundation, ONCC, or ONSEdge Executive Director or President. Applicable Persons for the current year are listed in
Appendix A to this Form.

C. Obligation to Notify Affiliated Organizations. Any Applicable Person required to complete this Form shall provide the
Executive Assistant to the CEO or Executive Director written notice of any changes or updates to the information
provided on this Form within 60 days of the occurrence of such a change. The Applicable Person shall also update the
Disclosure Form online.

D. Failure to Comply with Reporting Obligations. Applicable Persons should complete this Form in good faith, based on
their personal knowledge at the time they submit the Form. Failure to complete this Form in good faith and in a timely
manner with the reporting obligations set forth in this Form without reasonable excuse, may serve as grounds for
disciplinary action, suspension, removal or revocation of any other benefits.

INSTRUCTIONS FOR COMPLETION OF THE FORM
The information requested in this Form is intended to ensure comprehensive disclosure of all actual and potential
conflicts of interest involving any Affiliated Organization, as well as all arrangements and other relationships that any
Affiliated Organization may be required to report under Federal law.

The broad nature of the questions posed may, in some cases, lead to repetitive answers. If you have fully disclosed a
transaction, arrangement, or relationship in response to one question on the Form, and another question appears to
require the disclosure of identical information, please note on the Form that the information has been provided in a
previous response on the Form and identify where that information is disclosed on the Form. Please note that
definitions of bolded terms are included in the attached glossary, Appendix B. A list of Affiliated Organizations major
vendors is included in Appendix C. ONCC Applicable Persons should refer to Appendix D for list of competing
organizations.

Please complete one (1) disclosure form inclusive of your role with the Affiliated Organizations.

II. APPLICABLE PERSON INFORMATION


A. NAME AND BACKGROUND INFORMATION

Name:
Address:
Telephone Number:
Titles/Positions with ONS Affiliate(s):
Date of Disclosure:
Conflict of Interest
28.00 Page 5 of 9

B. RELATIONSHIPS WITH OTHER APPLICABLE PERSONS

Employment. Are you employed by another Applicable Person in a sole proprietorship, or in an organization in which
another Applicable Person is a trustee, director, officer, or employee, or Owner? Do you employ another Applicable
Person in a sole proprietorship, or is another Applicable Person employed by an organization for which you are a
trustee, director, officer or employee, or Owner? If so, please identify the other Applicable Person and explain the
nature of the employment relationship.
Example 1: Board member A and Board member B are employed at the same institution.
Example 2: Board member A serves on the Board of XYZ hospital and Board member B is a nurse at the same hospital.
Example 3: Board member A owns a consulting service and Board member B is employed by the same consulting service.

Business Transactions. Do you transact business either directly or through an entity in which you serve as a trustee,
director, officer, employee or Owner with another Applicable Person? Do you transact business with a business for
which an Applicable Person is associated as a trustee, director, officer, employee or Owner? If so, please identify the
other Applicable Person and the nature of the Business Transaction, including the amount of money involved for each
transaction, or if transactions are on-going, the total amount of money involved for the current fiscal year.
Example 1: Board member A works for XYZ Pharmaceuticals as an employee and Board member B conducts consulting
services for XYZ Pharmaceuticals.
Example 2: Board member A serves on the board of XYZ hospital and XYZ hospital is going to enter into a contract with
Board member B’s management company.
Example 3: Board member A is an officer of XYZ hospital and XYZ hospital wants to purchase equipment from the
company that Board member B serves as an employee.

Other Relationships with Applicable Persons. Do you serve as director, officer, trustee, or greater than 10 percent
Owner in a for-profit entity (other than ONS Edge) for which another Applicable Person also services as director, officer,
trustee, or 10 percent Owner? If so, please identify the other Applicable Person and describe the nature your
relationship.
Example: Two Board members co-own a nurse consulting company (or any business)

Family Relationships. Is any other Applicable Person your Family Member? If so, please identify such individual(s).

C. RELATIONSHIP WITH AFFILIATED ORGANIZATIONS
Compensation. Have you or any Family Members received any compensation from any Affiliated Organization in the
current fiscal year and in any of the past 5 years? If so, please provide the amount of the payment and any services,
products, or benefits provided in return. If a Family Member is the recipient of compensation or other payments, please
identify the Family Member.
Example: Board member A serves as a speaker at an ONS program and receives an honorarium from ONS.

Grants/Other Assistance. Have you or any Family Member, or any entity in which you or a Family Member has
Ownership received any grant or other assistance from the ONS Foundation in the current fiscal year?
Example: An ONS Board member receives a grant or scholarship from the ONS Foundation.

Business Transactions. Identify any Business Transactions that took place during any of the past five and current fiscal
year, are on-going from a previous fiscal year between:

       an Affiliated Organization and you,
       an Affiliated Organizations and your Family Member,
       an Affiliated Organization and any entity Owned individually or collectively by you, Family Members, and/or
        other current and former Applicable Persons, or
Conflict of Interest
28.00 Page 6 of 9

       Affiliated Organizations and any taxable entity, if, at the time of the transaction, you then served as such entity’s
        officer, director, trustee, employee, partner (or shareholder if the entity is privately held). For any such
        transaction, identify the nature of the transaction, the date of occurrence, as well as the amount and the parties
        involved.

Example 1: Board member A’s husband owns an IT service company that provides IT services to ONS.
Example 2: An ONS key employee’s husband owns a landscaping business and contracts with ONS to provide landscaping
services.
Example 3: A key employee also serves as a director of an outside business that is engaged in business with ONS.

Investments. Identify any investments that you or a Family Member has or had during the last five years in any entity
that has, does, or is likely to provide goods or services to, or to compete with an Affiliated Organization.

Other Services. Identify any services that you or a Family Member provides or provided with the last five (5) years or as
a director, trustee, partner, principal, manager, employee or consultant to any organization that does, has, or is likely to
provide goods or services to, or compete with a Affiliated Organization.

Board Service. Please identify all other entities (profit or nonprofit) for which you serve as a director, officer, or trustee.
Examples include (not all inclusive), local or national non-profit organization Board (e.g., ACS, Komen Foundation),
national nursing organization board, local or national business board.

Additional Disclosures. Please identify all other circumstances affecting you, your Family Members, or entities in which
you serve as a director, trustee, officer, employee, partner, or otherwise hold an interest that might appear to involve a
conflict of interest with any Affiliated Organization, and any other circumstances that could be viewed as use of
Affiliated Organization information for personal profit or advantage by you or your Family Members.

ACKNOWLEDGMENT AND SIGNATURE
To the best of my knowledge and belief, the above information is true and accurate. I have received a copy of the
Affiliated Organizations Conflict of Interest Policy and the Reporting Obligations set forth on this Form, which I have read
and understand, and I hereby agree to comply with them.


DATED this         day of        ,2       .


By: _____________________________________________________________________________________
Conflict of Interest
28.00 Page 7 of 9

                                                   Appendix A
                                                Applicable Persons
Applicable Persons for 2011-2012 include:
   1. All ONS and ONS Affiliate Boards of Directors and non-director members of any committee.

                For ONS:
                a) ONS Audit Committee
                b) ONS Nominating Committee
                c) ONS Steering Council

                For ONCC:
                a) ONCC Nominating Committee
                b) ONCC Test Development Committees

                For ONS Foundation:
                a) ONS Foundation Nominating Committee

                For ONSEdge
                a) ONSEdge Nominating Committee

        3. Key employees as defined by IRS Form 990
Conflict of Interest
28.00 Page 8 of 9

                                                        Appendix B
                                                        GLOSSARY

Applicable Person. For purposes of this Form, an Applicable Person is defined as any person who is a current Affiliated
Organization officer, trustee, or member of a committee of the Board of Directors, as well as any person designated by
the ONS CEO or President. Applicable Persons for the current year are included on the list attached as Appendix A to
this Form.

Ownership. For purposes of this Form, Ownership is stock ownership (either voting or capital value) of a corporation,
profits or capital interest in a partnership or limited liability company, membership interest in a nonprofit organization,
or beneficial interest in a trust, which unless otherwise specified, exceeds 35 percent when the interests of the Covered
Person and Family Members are combined. Ownership also includes more than 35 percent Ownership in any entity that
has more than 35 percent Ownership in an entity that engages in the activity or transaction in question. For example, an
Applicable Person who owns more than 35 percent of a parent company that has more than 35 percent ownership of a
subsidiary is said to have ownership of the subsidiary.

Business Transactions. For the purposes of this Form, Business Transactions include, but are not limited to: contracts of
sale, leases, licenses, loans, guarantees, performance of services, or other transactions involving transfers of cash or
property. Business Transactions do not include transactions between an attorney and client, a medical professional and
patient, or a clergy member and a communicant; or charitable contributions to an Affiliated Organization for which the
Affiliated Organization does not provide any value other than a donor acknowledgement that the Affiliated Organization
provides to all contributors for contributions of similar value. Bargain sales or other transactions involving both a
donation of property or services as well as a payment by an Affiliated Organization are considered to be Business
Transactions.

Family Members. For purposes of the Form, Family Members include any: parents or grandparents, spouse, brothers or
sister (whole or half), children (natural or adopted), grandchildren, great grandchildren, and spouses of brothers, sisters,
children, grandchildren, and great grandchildren. Applicable Persons should use the best of their knowledge as it relates
to Family Members.
Conflict of Interest
28.00 Page 9 of 9

                                                    Appendix C
                                         ONS and ONS Affiliates Major Vendors
A J Jannetti Inc
ANP Transcriptions Inc
Applied Measurement Professionals, inc
ARAMARK
ASAP Software Inc
Barbara Keaton PH.D
Blackboard Inc
Brede /Arizona Inc
Campos Inc.
Carl Hamburg Associates Inc
CB Richard Ellis
Champ Printing Co Inc
Dell Marketing LP
Ditto Document Solutions
Dolce Atlanta Peachtree
Drinker Biddle & Reath LLP
Elsevier
e-Staff Consulting Group Inc
Federal Express
First Impression Printing Co Inc
Heeter Printing Inc
Herrmann Printing Inc
Hyatt Regency Pittsburgh Intl Airport
Impact Media Solutions Inc
Infocus Marketing
IPC Print Services
J. Brandt Recognition Ltd
Knepper Press
Leading Authorities Inc
Mae Marketing Corporate Gifts
Marriott International
McGrath Communications Group Inc
McGroarty & Bradburn Insurance
McKinley Marketing Inc.
Navigator Printing Company
NCS Pearson Inc.
Oxford Development Company
Pearson VUE
Pittsburgh Mailing
Richardson Copy Concepts
Roberts Event Group Inc
Rycon Construction, Inc.
Southwest Audiovisual Inc
Survey & Ballot Systems Inc
Transportation Management Services
                   ONCC EXAMINATION RELATED PROPERTY RIGHTS AND SECURITY REQUIREMENT

        The security of all Oncology Nursing Certification Corporation (“ONCC”) examination materials is extremely
important in protecting the integrity of the examination and is of utmost concern to the ONCC and its testing company,
Pearson Vue. The compromise of an examination form or individual items could be very costly, including, for example,
the cost to write, print, and administer a new examination and/or to retest candidates.

       ONCC appreciates your assistance in its examination development and/or review activities as well as your
agreement to protect ONCC’s trade secrets relating to the examination. Your participation in ONCC’s examination
development and/or review process is conditioned upon your agreeing to the following:

        1. To waive all rights relating to assistance you provide, have provided or will provide to the development and
        item-writing of any and all proposed or actual ONCC examinations. Such assistance is contributed by you to
        ONCC, without further consideration, on a work-made-for-hire basis. Any items or works you submit to ONCC
        must be original and unpublished material, and are the sole property of ONCC. ONCC, as sole owner of such
        items and works, may, in the sole discretion of ONCC, use such items and works in any manner, or not at all,
        and/or may create derivative works or compilations from such items or works or parts thereof.

        2. In your participation with ONCC’s examination development and/or review, ONCC may entrust in you
        confidential ONCC trade secrets relating to the examination. You agree to hold in confidence all matters and
        information pertaining to ONCC and to all ONCC examinations and examination related materials obtained,
        prepared or reviewed by you in connection with your involvement with ONCC. In particular, you shall not
        disclose ONCC matters including, but not limited to, matters concerning the development, production,
        administration, scoring or reporting of any ONCC examinations, examination questions and answers, scoring
        standards, identity of candidates, performance of candidates, results of examinations or your evaluation of
        examinations. You shall not release any materials connected with ONCC or any ONCC examinations, questions
        or examination related documents to any person or entity, or make examination materials available for any
        purpose whatsoever, separate from your specific assistance as authorized by ONCC. You will not copy or retain
        any examination questions or materials for your files. You will keep examination materials under secure
        conditions and shall lock up all examination materials when not directly working with them. All ONCC
        examination materials shall be submitted to ONCC in a secure manner (as identified by ONCC), or destroyed by
        you if you are instructed to do so by ONCC.

        3. If you breach this agreement in any way, you shall no longer be eligible to serve ONCC in any capacity, and
        ONCC shall be entitled to obtain from you injunctive relief, specific performance, damages, costs and attorneys’
        fees including costs and fees incurred in obtaining any such relief.



Signed this       day of       , 20

___________________________________                     ___________________________________
Name (Printed)                                  Signature


2011 ONCC Election



October 2002, March 2005, April 2006
                   Oncology Nursing Certification Corporation

                                                                          Nominations and Elections
                                                                               Campaigning

                                                                              8.05        Page 1 of 1


Information regarding the candidate, which is obtained from the nomination packet, may be communicated to certified
nurses via materials mailed with the ballot and posted on the ONCC Website.

The following campaign activities are prohibited:

        1.      Solicitation of funds.
        2.      Corporate sponsorship.
        3.      Formal, direct campaign mail from the candidate or anyone else on behalf of the candidate.
        4.      Formal telephone or Email campaigning.
        5.      Formal verbal or written campaign materials regarding a specific candidate.
        6.      Formal endorsement by current ONCC Board members.

The campaign policy shall be sent to all who request the nomination packet, along with the packet.

The ONCC Board of Directors shall have the right to remove a candidate from the ballot or void a candidate’s election as
a result of violation of the campaign policy.




I have read, understand, and agree to comply with the above Nominations and Election Campaigning Policy.



Signature                                               Date




3/00, 3/01, 3/02

                                              ONCC Policy Manual
                                         CHECKLIST FOR NOMINEES



               To assure fair consideration of your nomination, please make sure all of the following are submitted to:


                                     Oncology Nursing Certification Corporation
                                               125 Enterprise Drive
                                               Pittsburgh, PA 15275
                                        Email: onccnominations@oncc.org
                                                 Fax: 412-859-6168



_________________________ Nomination form (submit via email to onccnominations@oncc.org)

_________________________ Mission statement form (submit via email to onccnominations@oncc.org)

_________________________ Conflict of Interest policy signed by nominee See Policy 28 – Pages 4 & 6 of 9 for
                          signature lines (return via mail or fax)

_________________________ Examination Related Property Rights and Security Requirement form signed by nominee
                          (return via mail or fax)

_________________________ Campaign Policy form signed by nominee See Policy 8.05 for signature line (return via
                          mail or fax)

_________________________ Nominee's Curriculum Vitae or resume (submit via email to onccnominations@oncc.org)

_________________________ Reference Form 1 (submit via email to onccnominations@oncc.org)

_________________________ Reference Form 2 (submit via email to onccnominations@oncc.org)


Deadline for submission: July 25, 2011

				
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