ASSOCIATION OF YALE ALUMNI OF PUBLIC HEALTH (AYAPH) BOARD OF DIRECTORS 2015 Nomination Form I wish to recommend _____ myself / _____ a fellow alumnus for consideration as a candidate for the 2015 AYAPH Board of Directors election Important note: Self-nominations are strongly encouraged. I. Nominee Name (please print) Graduation Year YSPH Concentration/Major Address City/State/Zip Business telephone Current Title Home telephone Fax number E-mail address Current Employer I. What particular strengths, interests and/or abilities do you feel you (or the nominee you are recommending) would bring to the AYAPH Board of Directors? II. What drives your desire (or your nominees’) to serve on the AYAPH Board of Directors? III. Please provide a brief bio to help the Board better understand your professional background. If you are recommending an alumnus other than yourself, please fill out the information below: Your Name (please print) Graduation Year YSPH Concentration/Major Address City/State/Zip Business telephone Home telephone Please email the form to dedeot@gmail.com. SUBMISSION DEADLINE: Tuesday August 4, 2015 Fax number E-mail address