2025-2027 CSHA Board Nomination Form
Thank you for your interest in serving on as CSHA's Board as a District 9 Director.  Nominations for this position are due no later than 11:59 p.m. on January 12, 2025. Nominations that don’t meet submission requirements, or arrive after the posted deadline, will not be considered out of fairness to others.
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First and Last Name of Person Completing this Form.  *
First and Last Name of Nominee (Self nominations are permitted) *
Please provide the nominator and nominee's email address below.  *
Please provide the nominee's phone number below.  *
What position are you nominating for?  *
How are you connected to District 9? Please check all that apply.
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Is the Nominee a CSHA Member *
Please include your candidate statement here:  Each candidate  is allowed a maximum of 100 words to describe their reasons for seeking office. Please note, this statement will be publicized to all members. 
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Please attach your letter of intent here describing the position being sought and level of  interest in serving on the board. 

The letter shall include: 

a. Present professional position and employer. 

b. Educational degrees earned, institution granting the degree and date conferred. 

c. Past leadership and/or governance positions held in CSHA, ASHA  or in other professional and/or community organizations.

d. A statement of no more than 500 words which may include information about how the individual has demonstrated the expected competencies for the  position being sought, what they believe to be the major issues facing the field and CSHA, the skills they would expect to contribute to the board’s governance role, or any other relevant information.

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