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Cleveland Community Leadership Board Nomination Form

   

 
 

Thank you for your interest in the American Diabetes Association. Our Mission -- "to prevent and cure diabetes and to improve the lives of all people affected by diabetes" - is accomplished by the time, talent and treasure of our Board members and volunteers.

The Northeast Ohio Community Leadership Board of the American Diabetes Association has two components - an Akron-Canton Board and a Cleveland Board. Each Board has a different geographic focus, although the Boards meet at the same time and work together to address the various issues and opportunities pertaining to people with diabetes, and to have a greater impact on the Association’s Strategic Plan.

 
Question - Not Required - Please indicate which Board component is of interest to you:


 

(Please type or print. Attach additional page if needed)
  Please fill in the below:

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Name:

 

 
   

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City/State/ZIP:

 

    

 

 

 

 What's this?

   


   


   


 
Question - Not Required - AGE




 


 


 

 

 

 

 
Question - Not Required - Which of the following prompts your interest in the American Diabetes Association?

   


 
Question - Not Required - Please check those areas in which you now feel you are most likely to get involved. The details of these will be discussed with you before a decision is made.

 

 

 

 

Board Members lead the way to a life free of diabetes and all its burdens.
   


   Please leave this field empty

 

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American Diabetes Association • 1701 North Beauregard Street • Alexandria, VA 22311 • 1-800-DIABETES (800-342-2383)

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