2018-2019 NOHIMSS Board Nomination Form

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* 1. Full Name

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* 2. Organization Name

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* 3. Title

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* 4. Email Address

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* 5. Contact Phone Number

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* 6. Have you been a member (in good standing) of HIMSS and NOHIMSS for over 1 year?

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* 7. Are you nominating yourself or someone else?

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* 8. If you are nominating someone else, please enter their: Name, Organization, Title, Email Address, & Contact Phone Number.  If you are nominating yourself, please enter: N/A

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* 9. What NOHIMSS Board Position is your nomination for?

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