RHEC X Application for Membership
The Region X Health Equity Council (RHEC X) is one of 10 regional health equity councils formed with the aim to achieve health equity in the US. RHEC X currently is recruiting new members from the fours states that comprise the US Department of Health and Human Services Region X.

To apply, please submit this application form and your resume/CV. Thank you for your interest in joining RHEC X!

Contact Information
YES, I want to join the Region X Health Equity Council!
Name *
Your answer
Title
Your answer
Organization
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Daytime Phone Number(s) *
Your answer
Email Address *
Your answer
Which state do you represent?
List Areas of Expertise or Interest
Your answer
Application Questions
1. What is/are the main reason(s) you are interested in becoming a member of the Region X Health Equity Council (RHEC X)? *
Select one or more of the following:
Required
2. What passions, skills, education, or life experience do you bring to RHEC X? *
Select one or more of the following:
Required
3. All RHEC X members are expected to join at least one working group or committee. *
Select one or more committee.
Required
Submit Application Form
Once you have answered all questions above, upload your resume/CV below and click "submit".

All application materials must be submitted by 11:59 pm EST February 9, 2018.

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