OAHQ Board Application Form

OAHQ Board Application Form

Thank you for your interest in serving on the board of the Ohio Association for Healthcare Quality (OAHQ). All of those serving on the board are required to be members of OAHQ and actively engage and participate in board activities, including attending at least 75 percent of scheduled monthly board meetings. The time commitment for a board member ranges from one to three hours per month, depending on the position and current initiatives.
- Name*
  
  First NameLast Name
- Postnominals*
- Cell Phone*
  Please enter a valid phone number.Format: (000) 000-0000.
- Please upload your CV/résumé:*
  
  Cancelof
- Please upload your professional photo/headshot:*
  
  Cancelof
- Please enter a short bio for the board to introduce you to OAHQ members:*
- LinkedIn Profile
  https://www.linkedin.com/in/yourusername
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- If answering yes to any of the above conflict of interest questions, please provide a detailed description of the conflict of interest or apparent conflict of interest:
- By completing and signing this application, you attest and certify that all of the information on this form and the materials submitted to are true and correct to the best of your knowledge, and that you have made reasonable efforts to assure that accurate and complete information has been provided.
- Signature
- Please verify that you are human*
- Should be Empty: