Application for Fellow Board Position

CONTACT INFO
Please include the best email for us to contact you regarding this inquiry.
Please include the best phone number for us to contact you regarding this inquiry.

  

ABOUT YOU

  

INTERESTS/COMMITMENT

Video Interview Questions

Answer the following questions in order:

1. How many years of experience do you have in the ambulatory care setting?

2. Tell us about your current role

3. Explain your skill set and the contributions you could offer as a member of the Board

4. What do you hope to gain through your participation in the Board?

5. Describe your experience in working and collaborating in groups or volunteering.

Once you submit your application, you will receive instructions on how to upload your interview.

  

To complete the application process, please attach your current curriculum vitae (abbreviated with the qualifications for this role) or resume.
One file only.
32 MB limit.
Allowed types: pdf, docx.

  

SIGNATURE & DATE
The information provided in this application is accurate and complete.