Please read Guidelines and Procedures for Election of Directors for CQHA Board of Directors on CQHA Website before completing this application form.
- Must be received in the AQHA office on/before October 23, 2020.
- Type or print in blue or black ink, or complete electronically using Microsoft Word; may not be altered or amended; and must be four (4) pages only.
- Utilize the space(s) provided; additional attachments will not be provided to the Nominations Committee.
- Submit a photo with your application; photo will not be returned.
- Letters of recommendation should be sent directly toCQHA from the providing referee, individual, etc. and received prior to November 1, to be provided to the Nominations Committee CQHA.
- Unless otherwise indicated by applicant, application is submitted for Elected Director position created by a vacancy or new opening per Director allocation.
Any questions regarding the eligibility or requirements for becoming an CQHA Director should be directed to Dr Wayne Burwash Chair Nominations Committee: