Clone of IPHA Executive Council

Executive Council - Nomination Form

Please complete all information requested below.
The IPHA Executive Council is calling on all IPHA members to nominate themselves or other individuals to be considered for Executive Council positions. We are seeking candidates who (1) are active members, in good standing, of IPHA, (2) are working to improve public health in Illinois, (3) possess a keen interest and experience in public health, (4) have enthusiasm, motivation, and dedication to advance IPHA’s mission; and (5) are willing to participate actively in decision-making and fundraising efforts.

Available Executive Council Positions:
- President-Elect (2-year term)
- Executive Council-at-Large Member (3-year term)
- Affiliate Representative to the Governing Council (ARGC) (3-year term)
Qualifications:

To be eligible for election, a person must be a current member, in good standing, of the Illinois Public Health Association.

Read more about the available Executive Council Positions here.

Thank you for your willingness to serve your Association,

Duane Stevens, President

Tom Hughes, Executive Director
Candidate Information
Name*

Last NameFirst Name
Formal Title (e.g., MD, PhD, JD, MPH, MBA, etc.)
Preferred Pronouns*
Preferred Email*
example@example.com
Preferred Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
Alternate Phone Number
Format: (000) 000-0000.
Company/Organization/School or University (enter N/A if retired or not working/in school at this time)*
Title/Profession (e.g., Administrator, manager, student, retired)*
IPHA Executive Council Nomination Candidate Information
President-Elect (2-year term)Executive Council Member-At-Large (3-year term)Affiliate Representative to the Governing Council (3-year term)
Upload your Photo/Headshot (Upload Here) *

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Use the space below to provide information about your work in public health, why you wish to be elected to the IPHA Executive Council, and any other information you would like IPHA members to know about you and your candidacy.*
Upload a copy of your resume or CV*

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I certify that I am a member of the Illinois Public Health Association in good standing, and I am qualified for the office which I seek.
Signature*
Thank you for interst in serving on the Illinois Public Heatlh Association Executive Council.

Nominations will be accepted until 5:00 PM on April 3, 2026.

Voting will take place in May 2026. Elected candidates will take office at the first Executive Council Meeting of the FY2027 on July 23, 2026, 2025.

For more information, please contact Conny Moody, IPHA cmoody@ipha.com or 217-522-5687.
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Executive Council - Nomination Form

Candidate Information

IPHA Executive Council Nomination Candidate Information