HMHBGA Working Groups Interest Form
Are you interested in participating in future working groups? Join Healthy Mothers, Healthy Babies Coalition in our work towards improving maternal and infant health in Georgia.
Email *
First Name *
Last Name *
City of Residence *
Which working group are you interested in joining? *
Required
What days are best for you for meeting days?
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
List your professional experience and areas of expertise. *
Do you have a vested interest in the issues? Can you commit to attending four quarterly meetings and joining a specific initiative to do collaborative work in between meetings? Please be aware that there is no call-in option for work groups. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy