TETAF Board Nominations

Nominee's email address(Required)

Nominee's cell phone number(Required)

Nominee's city of residence(Required)

Nominee's primary Regional Advisory Council (RAC)(Required)

Nominee's employer(Required)

Experience/background of the nominee and reason for recommendation(Required)

What is the nominee's involvement in trauma care, emergency care, acute care, or perinatal care?(Required)

Describe the nominee's involvement in the local, regional, and/or statewide health care system? (Ex: TETAF, RAC, GETAC, PAC, etc.)(Required)

Any additional information you would like to share about the nominee?

Phone number of person submitting the nomination.(Required)

Email of person submitting the nomination.(Required)

If you would like to share additional information, such as a letter showing the nominee's active participation with their Regional Advisory Council (RAC) or a letter of recommendation from a RAC, please upload it here. If you would like to submit the attachments at a later time, please email them prior to the deadline to info@tetaf.org.

Drop files here or

Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 50 MB, Max. files: 2.

TETAF Board of Directors Nomination Form

TETAF Board of Directors Nomination Form

(512) 524-2892