HIMSS NCA 2023-2024 Charity Program Application

Please fill out the following details to be considered for the HIMSS NCA 2023-2024 Charity Awards. 

Applicants must complete and submit this application by Friday, April 19th, 2024.

For any questions, please email HIMSS NCA Charity Chairperson, Ann Wolford-Connors, at awolfordconnors@guidehouse.com.

Sign in to Google to save your progress. Learn more
Email *
Organization Name *
Organization Address *
Organizations Website URL *
What kind of organization are you? *
What is the primary focus for your organization? *
What is the health information technology need for which you would use the HIMSS NCA Charity Award money (ie: telehealth, computers)?
*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy