The PHIMA Nominating committee is currently soliciting candidates for the Year 2008 PHIMA ballot for the offices of:

Due to the critical nature of these positions and their resulting impact on the present and future of PHIMA and our profession, we would like to have at least one candidate for each office from each of the regions.  As an officer you have the additional bonus of being able to network with the other members of the Board and, believe it not, to enjoy the commitment with people you like and respect.

If you, or someone you know, are interested in running for one of these positions, please review the brief description of the duties and guidelines for each PHIMA Officer and complete the Nomination Application.   Please note, if you are elected you will be required to attend the PHIMA Leadership Meeting, Business Meeting and Installation of Officers held during the PHIMA Annual Meeting in May.  More information is available upon request. 

If you would like more information on a PHIMA office or candidate qualifications, please do not hesitate to contact the Nomination Chairperson, Carole Gammarion at 1-610-265-5516 or at cgammarino@precysesolutions.com.

Application

*required information

*PHIMA Position/Office

Select One President-Elect Secretary Treasurer Director Delegate

About the Nominee

*AHIMA ID:
*First Name:
*Last Name:
Credentials:
*Home Address:
Address (cont'd):
*City:
*State:	Select One Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Vigin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon International
*Zip Code:
*Home Phone:
*E-mail:

Professional Activity

Current Employer:
Title:
Business Address:
Address (cont'd):
City:
State:	Select One Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Vigin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon International
Zip Code:
Work Phone:
Fax:

Please indicate all settings in which you have worked:

To select more than one, select the Ctrl key and click on your selections. Acute Care Ambulatory Care Corrections Facility Drug/Alcohol Rehabilitation Education Home Health Long Term Care Mental Health Physical Rehabilitation Physician Practice Transcription Vendor Other:

Educational Background

Volunteer Experience

Please list if you have if you have held an office, been a chair or member of a committee or nay other involvement within the last 7 years.  Please include dates of service.

AHIMA
PHIMA Committee or Officer
Regional Office or Committee
List the last 7 years of PHIMA Annual Meeting you attended

Items you included will be used to determine your eligibility and will serve as the basis for your CV that is available on the PHIMA website.  You will be contacted to verify/approve your final CV.