MHA Board Member Nominating Form

Last Name *

First Name *

Email Address *

Residential address (and mailing address if they differ) *

After the election, we have to sed our updated list of board members to the state for our non-profit registration.

Phone *

Organization *

Organization’s Website/URL

150-word statement for PR and the ballot *

Why do you want to be on the MHA board of directors? What do you bring to the table? What else tdo you want the member organizations to know about your candidacy?

150-word BIO for PR and the ballot *

Please upload a photograph of yourself for the website and the ballot *

Maximum file size: 2MB

Specs: jpeg, portrait, at least 600 pixels wide

Tell us what you might like to get involved in. Or ask any question.

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