Trustee Awards Nomination - Texas Healthcare Trustees

Questions?

For more information, contact Safrat Wague, Advisor of Trustee Programs & Engagement at 512/465-1015.

Jessie Mundfrom, Education Manager at 512/465-1598

Award:(Required)

Founders’ Award
(awarded for excellence in health care governance)

THT Governance Achievement Award
(awarded for a hospital board showcasing effective Governance and selfless service)

The Ollie Jo Bozeman Excellence in Administrative Professionalism Award
(awarded for playing a critical role in the activities of the hospital’s board of trustees and governance)

Nominee Name:(Required)

Board Position:(Required)

Hospital/Health Care System:(Required)

Hospital Address:(Required)

City:(Required)

State:(Required)

Zip:(Required)

Nominee's name as it should appear on award:(Required)

(nominee will only be contacted if selected)

Address:(Required)

Apt/Suite:

City:(Required)

State:(Required)

Zip:(Required)

Phone:(Required)

Email:(Required)

Summarize the nominee’s contributions to health care governance and advocacy. Note involvement in local board, community and any Texas Healthcare Trustees, Texas Hospital Association or American Hospital Association activities. Include supplemental information or documents that address activities and accomplishments of the nominee as a member of the board of trustees or as a result of community, civic and service activities. Maximum length 1,000 words. No more than three additional pages of supporting documentation may be attached.

Narrative of Nominee's Contributions:(Required)

Name:(Required)

Affiliation with Hospital/Health System:(Required)

Address:(Required)

Apt/Suite:

City:(Required)

State:(Required)

Zip:(Required)

Phone:(Required)

Email:(Required)

Upload up to 3 pages of additional supporting documentation here. Be sure to click “Start Upload” once you have selected the files.

Attach Files:

Drop files here or

Max. file size: 50 MB.

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