Please complete this survey by January 1, 2018. If you have any questions, please contact us at ahe@aha.org or 312-422-3860.

We will reach out to you regarding committee selections in mid-January.
Last Name:

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* 1. Last Name:

First Name:

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* 2. First Name:

Full Name, Including Credentials, As You Wish it to Appear on AHE Materials:

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* 3. Full Name, Including Credentials, As You Wish it to Appear on AHE Materials:

AHE Member Number:
(This number may be found by logging into your ahe.org account or by calling us at 312-422-3860)

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* 4. AHE Member Number:
(This number may be found by logging into your ahe.org account or by calling us at 312-422-3860)

Degree(s) and Certification(s):

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* 5. Degree(s) and Certification(s):

Organization:

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* 6. Organization:

Job Title:

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* 7. Job Title:

Mailing Address:

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* 8. Mailing Address:

E-Mail Address:

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* 9. E-Mail Address:

Phone Number:

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* 10. Phone Number:

Cell Phone Number (optional):

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* 11. Cell Phone Number (optional):

2018 Committees


Advisory Council Assist members and staff with daily challenges of the EVS profession, assist with operational aspects of executing the strategic plan, identify potential partnerships/collaborations, and provide feedback on regulatory and guidance issues as needed.

Education and Knowledge Management Committee Continuously assess the educational and professional development needs of the membership. Develop and deliver educational products, including courses, training's, publications, products, and services.

Industry Advisory and Innovations Task Force Provide AHE with ah voice and support of industry, with the goal of mutually beneficial outcomes.

Nominating Committee Recommend and evaluate a slate of candidates for the Board of Directors.

Recognition Task Force To recognize AHE members for their individual contributions to caring for the healthcare environment and to promote recognition activities within the membership community.

*Committee appointments are typically for one year, beginning in January.   Committee charges will be developed by the individual committees during their first meetings. 
Please select the committee(s) on which you would like to serve from the list below. If choosing more than one, please rank your preference by selecting 1st, 2nd, or 3rd choices (please do not select more than three choices).

Please note that the Advisory Council and Nominating Committee are by invitation-only. If you are interested in being considered, please also see Question 17.

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* 13. Please select the committee(s) on which you would like to serve from the list below. If choosing more than one, please rank your preference by selecting 1st, 2nd, or 3rd choices (please do not select more than three choices).

Please note that the Advisory Council and Nominating Committee are by invitation-only. If you are interested in being considered, please also see Question 17.

Some members choose to be active on more than one committee. If you ranked more than one committee in Question 14, please let us know how many you'd like to participate on:

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* 14. Some members choose to be active on more than one committee. If you ranked more than one committee in Question 14, please let us know how many you'd like to participate on:

Please indicate if you are interested in serving as a committee chair or co-chair.

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* 15. Please indicate if you are interested in serving as a committee chair or co-chair.

I am interested in being considered for appointment to the Advisory Council or Nominating Committee (Interviews and references will be required):

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* 16. I am interested in being considered for appointment to the Advisory Council or Nominating Committee (Interviews and references will be required):

There are additional opportunities for AHE member involvement beyond serving on committees. Please indicate below if you have an interest in any of the following:

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* 17. There are additional opportunities for AHE member involvement beyond serving on committees. Please indicate below if you have an interest in any of the following:

Please indicate any specific qualifications for selected role(s):

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* 18. Please indicate any specific qualifications for selected role(s):

Please indicate why you are interested in serving in this role(s):

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* 19. Please indicate why you are interested in serving in this role(s):

Please let us know your past history volunteering with the AHE.

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* 20. Please let us know your past history volunteering with the AHE.

Please list the committee and position held for organizations outside of the AHE, if applicable.

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* 21. Please list the committee and position held for organizations outside of the AHE, if applicable.

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