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Call for Nominations
Candidate Bio Form


Deadline for Submission:  March 21, 2008

If you have any questions, please contact Dolores Stephens, MS, RHIT.

*Candidate Position

*First Name
Middle Initial
*Last Name
Credentials
*Brief Bio
 
Position Statement If elected, how would you enrich the membership while serving in this role?
*Position Statement Answer
   

Current Employer

Job Title
Employer Name
Dates of Employment
 
City
State
   

Previous Employers

Job Title
Employer Name
Dates of Employment
City
State
   
Job Title
Employer Name
Dates of Employment
City
State
   
Job Title
Employer Name
Dates of Employment
City
State
   
Job Title
Employer Name
Dates of Employment
City
State
   
Job Title
Employer Name
Dates of Employment
City
State
   

Education

   
School
Degree Name
Graduation Date
   
School
Degree Name
Graduation Date
   
School
Degree Name
Graduation Date
   

AHIMA Activity

MdHIMA  Activity

Local/Regional Activity

Other Professional Activity

Photo

Please email your photo.
 

Bio Review

After you select "submit your bio" below, you will have the opportunity to review your submission. 

Any duplicate submissions will be deleted, and the most recent submission will be maintained.     

If you need to make a change to your bio, please email us

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