HOHC Voting Member Form

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Aloha Hawai'i Oral Health Coalition members,

Please use this form once a year to become (or confirm) your voting membership. Please note that joining a committee is required to become a voting member. You may join a committee here: https://www.hawaiioralhealthcoalition.org/Join-us

Thank you!

With aloha,

Patrick Donnelly

Hawai'i Oral Health Coalition
Hawai'i Public Health Institute
www.hawaiioralhealthcoalition.org
https://www.hiphi.org/oralhealth/

Name

Organization and Title

Would you like to be a voting member for the HOHC for this year?

Yes

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Please confirm by checking boxes below that you have met all the requirements to become a voting member:

I have joined an HOHC Committee

I will do my best to participate in at least 75% of the meetings this year for the HOHC Committee I have joined

I will do my best participate in the HOHC Annual Statewide meetings this year

Please type your name here as your signature for this form.

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