Nomination Form

The Changing and Saving Lives Foundation board nominations are due Wednesday, December 10, 2025, prior to the Changing and Saving Lives Foundation® Annual Meeting and Board Elections on December 12, 2025, currently scheduled to be held virtually. For your information, please note the following criteria for board nomination:

The nominee must be nominated by the Changing and Saving Lives Foundation board of directors

The nomination must include a photo and bio of the nominated individual

Please complete this form and submit below with your photo and bio.

Be sure to upload your bio and photo. Otherwise, your submission won't go through.

* Indicates required field

Name *

First

Last

TITLE *

Company Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone *

Career Highlights *

Industry Involvement (other boards, programs): *

Goal of Serving on the Board: *

Factors for Consideration: *

Upload Your Bio *

Max file size: 20MB

Upload Your Photo *

Max file size: 20MB

Submit

2026 Changing and Saving Lives Foundation®Board of Directors Nomination Form

2026 Changing and Saving Lives Foundation®
Board of Directors Nomination Form