Board of Directors Nominations - Collaborative Family Healthcare Association

Please complete the following information about your recommendation for an appointed board member.

Your Name(Required)

First Last

Candidate's Name(Required)

First Last

Email(Required)

Please indicate whether you will submit a resume or a professional profile link for the candidate:(Required)

Resume (PDF or Word Document)

Link to their professional profile (e.g., LinkedIn page, Link to more information about person such as on their academic institution’s website)

Please submit a PDF using the file upload link below or add the link to the individual’s professional profile below.

Upload the candidate's resume here:(Required)

Max. file size: 50 MB.

Candidate's professional website URL:(Required)

Please select one or multiple of the following areas which this candidate fits:(Required)

Diversity, Equity, Inclusion, and health equity expertise

Payor representation

Health policy

Medical representation (e.g., MD, DO, Nursing, PA, NP, PharmD)

Why are you recommending this person to be a candidate for an appointed board member position?(Required)

Would you like to nominate a second candidate?(Required)

Yes

No

Please complete the following information about your second recommendation for an appointed board member. If you do not have a second candidate, hit “Next”.

Name(Required)

First Last

Email(Required)

Please indicate whether you will submit a resume or a professional profile link for the candidate:(Required)

Resume (PDF or Word Document)

Link to their professional profile (e.g., LinkedIn page, Link to more information about person such as on their academic institution’s website)

Please submit a PDF using the file upload link below or add the link to the individual’s professional profile below.

Upload the candidate's resume here:(Required)

Max. file size: 50 MB.

Candidate's professional website URL:(Required)

Please select one or multiple of the following areas which this candidate fits:(Required)

Diversity, Equity, Inclusion, and health equity expertise

Payor representation

Health policy

Medical representation (e.g., MD, DO, Nursing, PA, NP, PharmD)

Why are you recommending this person to be a candidate for an appointed board member position?(Required)

Would you like to nominate a third candidate?(Required)

Yes

No

Please complete the following information about your third recommendation for an appointed board member. If you do not have a third candidate, hit “Submit”.

Name(Required)

First Last

Email(Required)

Please indicate whether you will submit a resume or a professional profile link for the candidate:(Required)

Resume (PDF or Word Document)

Link to their professional profile (e.g., LinkedIn page, Link to more information about person such as on their academic institution’s website)

Please submit a PDF using the file upload link below or add the link to the individual’s professional profile below.

Upload the candidate's resume here:

Max. file size: 50 MB.

Candidate's professional website URL:

Please select one or multiple of the following areas which this candidate fits:(Required)

Diversity, Equity, Inclusion, and health equity expertise

Payor representation

Health policy

Medical representation (e.g., MD, DO, Nursing, PA, NP, PharmD)

Why are you recommending this person to be a candidate for an appointed board member position?(Required)