SHA BOARD APPLICATION FORM

The SHA Board will carefully review all applications and reach out to applicants once final selections are made. Please complete the information below to submit your application. Thank you for your time and interest.

Basic Information

First name

Last name

Title

Organization / Employer

Email Address

Phone Number

Current SHA Involvement

Are you currently a member of SHA?

Yes

How long have you been involved with SHA?

List any SHA committees, events, or initiatives you’ve participated in. (1-2 sentences)

Professional Background

Briefly describe your professional background and areas of expertise. (2-3 sentences)

Other Professional Affiliations

Please list any professional organizations you are currently or have previously been involved with.

For any of the listed groups, please identify committees on which you have served and briefly describe your role. (1-3 sentences)

Interest in serving

Why are you interested in serving on the SHA Board of Directors? (2-4 sentences)

What skills, perspectives, or experiences would you bring to the SHA Board? (2-4 sentences)

Availability & Commitment

Are you able to commit to attending bi-monthly board meetings?

Yes

Are you willing to actively participate on at least one committee or initiative?

Yes

Additional Comments (Optional)

Is there anything else you’d like the selection committee to know?

Signature & Date

Signature

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Submission Date

Month

Day

Year

SHA BOARD APPLICATION FORM

Basic Information

First name

Last name

Title

Organization / Employer

Email Address

Phone Number

Current SHA Involvement

Are you currently a member of SHA?

Yes

How long have you been involved with SHA?

List any SHA committees, events, or initiatives you’ve participated in. (1-2 sentences)

Professional Background

Briefly describe your professional background and areas of expertise. (2-3 sentences)

Other Professional Affiliations

Please list any professional organizations you are currently or have previously been involved with.

For any of the listed groups, please identify committees on which you have served and briefly describe your role. (1-3 sentences)

Interest in serving

Why are you interested in serving on the SHA Board of Directors? (2-4 sentences)

What skills, perspectives, or experiences would you bring to the SHA Board? (2-4 sentences)

Availability & Commitment

Are you able to commit to attending bi-monthly board meetings?

Yes

Are you willing to actively participate on at least one committee or initiative?

Yes

Additional Comments (Optional)

Is there anything else you’d like the selection committee to know?

Signature & Date

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Submission Date

Month

Day

Year

SHA BOARD APPLICATION FORM

Basic Information

Current SHA Involvement

Professional Background

Other Professional Affiliations

Interest in serving

Availability & Commitment

Additional Comments (Optional)

Signature & Date

SHA BOARD APPLICATION FORM

Basic Information

Current SHA Involvement

Professional Background

Other Professional Affiliations

Interest in serving

Availability & Commitment

Additional Comments (Optional)

Signature & Date