Board of Trustees Nomination

If you are interested in becoming an MPF Board Trustee or would like to nominate an individual for an MPF Board Trustee position, please complete the form below.

View the MPF Board Trustee Responsibilities and Expectations

Questions? Contact Rick Drabek at rdrabek@michiganpharmacists.org

MPF Board Nomination Form

Name

This field is for validation purposes and should be left unchanged.

Nomination Type(Required)

Self Nomination

Nomination of Another Individual

Your Name(Required)

Your Phone Number(Required)

Your Email Address(Required)

Nominee Consent Confirmation(Required)

Please confirm that your nominee is aware of this nomination, the 4 year term length, and the MPF Board of Trustee Responsibilities and Expectations.

Nominee is aware

Nominee not aware

Please inform the nominee of this nomination and The MPF Board Trustee Responsibilities and Expectations before submitting your nomination.

Nominee Name(Required)

Nominee Phone(Required)

Nominee Email(Required)

Nominee Address

Nominee's Employer

Nominee's Title or Position

Reason For Nomination(Required)

Please describe why you believe this individual would be an excellent addition to the MPF Board of Trustees. Please limit answer to ~1000 words maximum.

Nominee Professional Background & Experience

Share details about the nominee’s profession, employment history, or other experience that contributes to their qualifications. If you do not have this information we will reach out to the nominee directly using the email address provided for additional information.

Involvement in Activities and Organizations

List the nominee’s involvement in local, state, and national activities or organizations, including any leadership roles held. If you do not have this information we will reach out to the nominee directly using the email address provided for additional information.

Board of Trustees Nomination

MPF Board Nomination Form

Donate To The Foundation

Michigan Pharmacy Foundation

(517) 377-0227

rdrabek@michiganpharmacists.org

408 Kalamazoo Plz Lansing, MI 48933-1919