Mountain States Regional Health Equity Council (RHEC VIII) 2018 Membership Application
The Mountain States Regional Health Equity Council (RHEC VIII) is one of 10 regional health equity councils formed with the aim to achieve health equity in the US. RHEC VIII currently is recruiting new members from the five states that comprise the US Department of Health and Human Services Region VIII.


Note: Applicants should complete the information below and submit it along with a resume or CV and cover letter online by Sunday, March 18, 2018.

Thank you for your interest in joining RHEC VIII!

YES, I want to join the Regional Health Equity Council!
Contact Information
First Name *
Your answer
Last Name *
Your answer
Title *
Your answer
Organization *
Your answer
Address *
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? *
(Check one)
List Areas of Expertise or Interest *
Your answer
Please answer the following questions:
1. What is/are the main reason(s) you are interested in becoming a member of the Mountain States Regional Health Equity Council (RHEC VIII)?
Select one or more of the following:
2. What passions, skills, education, or life experience do you bring to RHEC VIII?
Select one or more of the following:
3. All RHEC VIII members are expected to join at least one working group or committee. Please choose which of the current committees you would like to be a part of:
Select one or more of the following:
Thank you for your interest in the Mountain States Regional Health Equity Council!
Submit Application Form
Submit this application along with a resume or CV and cover letter online by Sunday, March 18, 2018.
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This form was created inside of NPA RHEC.