Associate Board Application
Our Associate Board first came together in September 2009 as a way for emerging leaders to donate their time, skill, and experiences to make HealthConnect One a healthy and viable organization. We encourage you to complete this application if you support our mission and vision at HealthConnect One.
Name
First Name
Last Name
Preferred Name (if different from First Name)
Email
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please select the areas of expertise/leadership qualities you can bring to the Associate Board (select all that apply):
Clinical
Communications/ Public Relations
Community Engagement
Early Stage Organizations/Start-Ups
Event Planning
Finance/ Budget Planning
Fundraising
Government
Healthcare Administration/ Management
Human Resources
Legal
Leadership Skills
Marketing
Sales
Social Media
Strategic Planning
Technology
Wellness
Other
Please select the area(s) of expertise/ contribution you feel you can make to further the mission of HealthConnect One:
Fundraising
Special Events
Advocacy
Strategic Planning
Technology
Why are you interested in joining the Associate Board for HealthConnect One?
What personal qualities/ strengths are you most excited to bring to the Associate Board, and why?
Please share any other information you feel important for consideration of your application to serve as an Associate Board Member.
Please upload your resume.
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