Exit this survey 2017-2018 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. Recent clinical experience with focus on care-for-the-vulnerable, genomics, palliative care and/or behavioral health issues. Experience in maintaining and influencing a network of church relationships. Demonstrated understanding of theological/ethical issues. Expertise related to national healthcare policy on matters important to the Catholic health ministry. Ability to mobilize the ministry including expertise in communication strategies (i.e., social media and crowdsourcing). 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