Board of Directors Nomination Form

Board of Directors Nominating Form

Please enter your name: *
Your Email: *
The best phone number to reach you at: *
Are you nominating yourself or someone else?: *
I am nominating myself
I am nominating someone else
Name of Person you are Nominating (if someone other than yourself):
Comments/Additional Information:
Candidates must also submit a Board Candidate Profile (link below) and a letter of comittment.: *
I acknowldege that a Board Candidate Profile Form must also be completed


Thank you for submitting a nomination for the IHLA Board of Directors
 
Please download and complete the BOARD PROFILE FORM 
 
Submit the form and a letter of comittment by email to:  Director@iahealthcareleaders.org