Committee Membership Form
Healthy Little Havana's mission is to support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.  As the backbone of this collective impact, Healthy Little Havana's serves as an umbrella organization for community residents and organizations that share the vision of having a more prosperous community.

Healthy Little Havana's work is guided by its Community Action Plan (CAP), which separates activities into the following three health priority areas:
1. Housing
2. Education to Employment
3. Public Spaces
4. Health Care Access*

For each health priority area, a Committee has been established. Committee members will bring to bear their diverse and extensive expertise to ensure the success and growth of Healthy Little Havana strategies.

Please review the following membership information and consider joining a Healthy Little Havana Committee.

Overall Member Duties:
The primary responsibilities of Committee members include but are not limited to:
• PARTICIPATE in meetings, special events, and community functions to further Healthy Little Havana's mission and goals
• SUPPORT the development and implementation of mutually reinforcing activities that will assist with the sustainability of Healthy Little Havana;
• SERVE as ambassadors of Healthy Little Havana in the community

Committee Membership:
There are two types of Committee members, General and Active. There can be a maximum of 2 votes per community organization or stakeholder company/business.

1. General (non-voting) Member - Complete a member registration form.
2. Active (voting) Member - Completed a member registration form, complete a conflict of interest form, attended at least 2 previous committee meetings within the past year; attended at least half of the scheduled meetings in one calendar year.

Full Committee Operating Guidelines can be found at: https://docs.google.com/document/d/153bpFv1iyMaaBGmRHMWZEKFmAh_5HM9UmvPzo3eYu8Y/edit?usp=sharing

*Health Care Access is our most recent addition and while we are actively seeking new partners and would love to have you as a part of our network we are still in the process of formally conforming this Committee.
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I am a... *
Healthy Little Havana is comprised of four (4) committees listed below. Please select the committee(s) you are interested in becoming a member of *
Required
First Name *
Last Name *
Company/Organization Name *
Position/Title *
Email Address *
Phone Number *
On the committee, I am representing the organization/employer/business indicated above
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I am a resident of Little Havana *
My signature below affirms that I agree to be a General Member, agree to receive meeting materials and notifications, and agree to work collaboratively with the above-selected committee(s) of Healthy Little Havana. Once I have attended at least two meetings within the last year and 50% of the meetings in the current calendar year I will be designated as an Active Member and reserve the right to participate in Committee Votes. *
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