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Board Director Renewal - Medical

2022 Fantastic Summer - Second Session

Starts In

Southwestern Diabetic Foundation Board Membership
Congratulations!
At the April 23, 2022, Executive Board meeting, the board voted to extend to you an offer to renew your medical board membership. This three-year term is from July 2022 through July 2025.

Your participation in our program is vital to its success and we appreciate your commitment and service to these very special children.
Would you like to renew your membership?*
- Yes, I would like to renew my board membership for another term.
- No, due to other commitments, I will be unable to serve at this time.
Name*
First Last
We are sorry that you will not be able to renew your board membership at this time. We appreciate your past service and wish you the best in your future endeavors.
Date
MM slash DD slash YYYY
Optional Comments
We appreciate your willingness to renew your board membership. Please provide your updated information below if applicable.
Work / Business Information
Occupation/Industry (check all that apply)
- Healthcare
- Education
- Law
- Finance
- Retired
- Entrepreneur
- Other
Other Occupation/Industry
Employer/Business Name
Title/Position
Work Address
Street Address Address Line 2 City State ZIP Code
Work Phone
Work Fax
Home / Personal Information
Home Address
Street Address City State ZIP Code
Home Email
Home Phone
Cell Phone
Spouse's Name
Children's names
Click the + sign to add more spaces
Your Birthday (Month and Day only)
Optional Comments
Preferred method of contact (check all that apply):
- Work Email
- Work Address
- Work Phone
- Cell Phone
- Home Address
- Personal Email
Date
MM slash DD slash YYYY

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Camp Sweeney

P.O. Box 918

Gainsville, TX 76241

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Camp Sweeney is a 501(c)(3) tax-exempt organization. Donations are tax deductible in the U.S. © 2022 Southwestern Diabetic Foundation, Inc.

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