ACHE-WI 2018 Board Application

Application for Wisconsin ACHE Chapter Board of Directors

Please complete the application below and submit your resume to ACHE-WI@badgerbay.co. Once your application and resume have been received, you will be sent a survey link for those that support your nomination. We require that 10 Chapter Members complete the brief survey to support your nomination. We will contact you once we have received 10 completed surveys. The application, resume, and 10 supporters must be submitted by September 14, 2017.

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* 1. Contact Information:

First Name

Last Name

Credentials

Title

Company/Organization

Work Address

City/Zip

Day Phone

Evening Phone

E-mail

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* 2. Why would you like to serve on the chapter board?

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* 3. Please describe your prior board or volunteer experience:

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* 4. What do you feel you can offer to this board that will assist in achieving the mission of the chapter?

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* 5. Please provide four points relative to your healthcare experience to be included on the ballot.
Note: Your name, credentials, title, company/organization, and city will be provided already.

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* 6. Have you sent your resume to ACHE-WI@badgerbay.co?
(If not, please do so as soon as possible.)

Yes

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* 7. Indicate areas in which you are interested in working:

Programming Committee

Membership Committee

Sponsorship Committee

Leadership Development Program

Other (please specify)

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* 1. Contact Information:

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* 2. Why would you like to serve on the chapter board?

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* 3. Please describe your prior board or volunteer experience:

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* 4. What do you feel you can offer to this board that will assist in achieving the mission of the chapter?

Question Title

* 5. Please provide four points relative to your healthcare experience to be included on the ballot.Note: Your name, credentials, title, company/organization, and city will be provided already.

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* 6. Have you sent your resume to ACHE-WI@badgerbay.co? (If not, please do so as soon as possible.)

Question Title

* 7. Indicate areas in which you are interested in working:

* 5. Please provide four points relative to your healthcare experience to be included on the ballot.
Note: Your name, credentials, title, company/organization, and city will be provided already.

* 6. Have you sent your resume to ACHE-WI@badgerbay.co?
(If not, please do so as soon as possible.)