Board of Trustees Nomination

Additional Nominee Information Form

Thank you for your interest in serving as an MPF Board Trustee. You have been nominated for this position, and we would like to learn more about your background and experience. Please complete the form below to provide additional information that will be included with your nomination.

View the MPF Board Trustee Responsibilities and Expectations

Questions? Contact Rick Drabek at rdrabek@michiganpharmacists.org

MPF Board Nomination

Additional Nominee Information Form

Company

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

Your Name(Required)

Your Phone Number(Required)

Your Email Address(Required)

Your Mailing Address(Required)

Employer(Required)

Title or Position(Required)

Professional Background & Experience(Required)

Please share details about your profession, employment history, or other experience that contributes to your qualifications.

Involvement in Activities and Organizations(Required)

Please list your involvement in local, state, and national activities or organizations, including any leadership roles held.

Nominee Consent Confirmation(Required)

Please confirm you are aware of the 4 year term length, and the MPF Board of Trustee Responsibilities and Expectations.

I am aware

I am not aware

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

Board of Trustees Nomination

Additional Nominee Information Form

MPF Board Nomination

Additional Nominee Information Form

Donate To The Foundation

Michigan Pharmacy Foundation

(517) 377-0227

rdrabek@michiganpharmacists.org

408 Kalamazoo Plz Lansing, MI 48933-1919