2023 Regional Liaison Candidate Form

Suggested Candidate Form

Please fill out this form and submit it by February 28, 2023 at 6:00 p.m. (PST). Late and incomplete submissions will not be considered.
Your Name and Credentials*

Full NameCredentials
Your Professional Membership (Name of WFMT Full Organisational Member or Individual WFMT Member)*
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Email Address*
WFMT Regional Liaison (Council appointment): Please review the job description, time commitment, and core strengths required for assuming the Regional Liaison position on the WFMT Council before suggesting your candidate.*

AfricaAustralia/New ZealandNorth AmericaLatin America and the CaribbeanSoutheast AsiaEuropeEastern MediterranienWestern Pacific
Your Candidate's Name and Credentials (Note: Candiate must be a professional music therapist and member of WFMT (as part of a member organization or individual member).*

Full NameCredentials
Candidate's Professional Membership*
Candidate's email address
Suggestion supported by*

Fulll NameCredentials
Your Rationale for suggesting your candidate (maximum of 250 words).*
Verification: By sumitting this form, I assure that the suggested candiadate*

is informed about this suggestion and agrees to serve on the 2023-2026 WFMT Council should she or he be selected.understands that she or he may or may not be contacted by the WFMT President after the 17. World Congress of Music Therapy in July 2023.
Date

MonthDayYear
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Suggested Candidate Form