Exit this survey 2018–2019 Call for CHA Board Nominations Candidate #1 Information Question Title Question Title * 1. Name of Candidate: Question Title * 2. Organization: Question Title * 3. Title or role: Question Title * 4. Address: Question Title * 5. City: Question Title * 6. State: Question Title * 7. ZIP Code: Question Title * 8. Phone: Question Title * 9. Email Address: Question Title * 10. Which of the following competencies would this candidate bring to the CHA board? Select all that apply. Ability to influence national policy. Ability to mobilize the ministry, to include system CEOs and/or system executive leadership team members. Recent clinical experience at various levels of the delivery system including transformational models of care (e.g., physician, nurse, allied health professionals). Ability to maintain/influence a network of church relationships, to include a bishop (either active or auxiliary) or ecclesial expert. Question Title * 11. Please provide additional comments about this candidate and the competencies that he/she would bring to the CHA Board: Question Title * 12. Please be sure to advise the person that you are nominating him or her for the CHA Board. Have you had the opportunity to do this yet? Yes No Question Title * 13. To help us determine the best way to solicit nominations, please let us know how you learned of this year's board nominations process. Catholic Health World Ad Email from CHA CHA website Other (please specify) Question Title * 14. Would you like to nominate another candidate? Yes No Next