WAWH Board of Directors Application
First and Last Name *
Your answer
Date of Application *
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YYYY
Primary Affiliation (Organization/Employer)
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Preferred Phone Number *
Your answer
Email Address *
Your answer
Educational background by school and degree *
Please note there are no specific degree requirements to serve on the WAWH Board
Your answer
Please share your experience and involvement in women’s health *
Your answer
Please share your thoughts on how you would like to contribute to the growth and sustainability of the Wisconsin Alliance for Women’s Health (2-3 sentences). *
Your answer
What knowledge and skills do you hope to gain by serving on the WAWH board? *
Your answer
Please indicate which board committee(s) you may be interested in serving on: *
Check all that apply. Note: You will only be required to serve on one committee.
Required
Person who nominated you or suggested you for the board of directors *
Your answer
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This form was created inside of Wisconsin Alliance for Women's Health.