AHVAP 2027 National Committee Application

AHVAP National Committee Application

Thank you for your interest in participating in a 2027 AHVAP National Committee. Please carefully review each portion of the application below and fully complete each section. If you need to save your application and return to complete it, you are able to do so. All applications must be received no later than November 20 at midnight ET. There are no exceptions to this deadline, so please plan accordingly.
Applicant Information
Full name

First NameLast Name
Professional Credentials
Facility Title
Company
Facility name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City/town
State/province
ZIP/postal code
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Membership and Committee Selection
Membership classification
Committee interest
Employment Setting

Other
Current CVAHP Board Certification
Highest level of education
Commitment and Eligibility Attestations
Supervisor supports participation in an AHVAP Committee, including attending a minimum of 80% of all scheduled committee meetings and, for Annual Conference Committee, participating in the AHVAP Annual Conference. Failure to meet this attendance requirement can result in administrative removal from the committee.
Willing to complete the mandatory Conflict of Interest, Confidentiality, and Nonprofit Leadership Training Orientation required for AHVAP National Committee participation
Required Uploads
Letter of Support from Immediate Supervisor

Cancelof
Cover Letter

Cancelof
Current CV or Resume

Cancelof
Should be Empty:

AHVAP National Committee Application

Applicant Information

Membership and Committee Selection

Commitment and Eligibility Attestations

Required Uploads