<p> NCAB STEERING COMMITTEE NOMINATION FORM Due to [email protected] no later than March 12, 2012</p><p>NCAB invites you to nominate yourself or a consumer for a position on the National Consumer Advisory Board Steering Committee. Consisting of seven NCAB members, the steering committee is responsible for organizing the consumers of Health Care for the Homeless so that they have a voice in national issues involving the health care of homeless persons. To accomplish this work, the committee meets monthly by teleconference and twice annually in-person; once in October at the Council headquarters in Nashville, Tennessee, and at the National Health Care for the Homeless Conference. Work is expected of each member in between meetings, as well.</p><p>Currently, four steering committee positions are open to any current NCAB member. Open positions include, Chair, Co-chair, and two Members at Large (all positions are two-year terms except one member at large and that is a one- year term). The NCAB nominating committee will review all nominations and select those best suited to the four positions to be added to a slate. The NCAB membership will confirm or change the slate by consensus during the annual membership meeting. Responsibilities of steering committee members* are listed below and the nominations/election process are available upon request.</p><p>Please use the form below to nominate yourself or a colleague and submit to NCAB via [email protected]. The Nominee section is required and must be completed separately by the person being nominated. Serving in this capacity provides opportunities for leadership development, collaboration with other consumers from around the country, and active participation in directing the NCAB’s work on the national level.</p><p>Nominee Nominator Information Name: Name: Position: Position: Agency: Agency: Mailing address (if any): Address (if any): City, State, Zip Code: City/State/Zip: Telephone (if any): Telephone (if any): Email: E-mail:</p><p>Statement by Nominator Tell why you believe the above-named nominee for the NCAB steering committee would make a valuable addition to the NCAB leadership team: To Be Completed by Nominee</p><p>Name: Mailing address (if any): City, State, Zip Code: Telephone (if any): Email: (if you do not have an email address, please contact Katy at 615-226-2292 or seek help in your community signing up for one. It is a requirement as most communication happens via email)</p><p>I am someone who (check all that are true) __ has ever been homeless __ has used Health Care for the Homeless services __ is a member of NCAB** (required for consideration) __ Is a member of a Consumer Advisory Board for (Name of Agency): ______Is a member of the Board of Directors for (Name of Agency): ______</p><p>**Join NCAB and the Council for free here: https://www.nhchc.org/about/membership/individual-members/individual- membership-application/ </p><p>Position sought (check one or more) __ Chair – two-year term __ Co-Chair – two-year term __ At-Large – two-year term __ At-Large – one-year term</p><p>Statement by Nominee Please provide a few sentences written by the nominee, describing your experience as a consumer, including your involvement with agency decision- making or governance, and what contribution you would make with your position to contribute to the work of NCAB:</p><p>Please note: You may provide additional letters of support or references to provide the nominating committee with additional information to support your nomination and enhance the nominating committee’s understanding of your potential contributions to the steering committee. The nominating committee may contact you for an informal interview if more information is needed. </p><p>Thank you for your interest in joining the steering committee of the National Consumer Advisory Board. *Responsibilities of all NCAB Members include:</p><p> Participation on monthly calls  Participation in at least one national NCAB project such as voter registration drive, consumer participation outreach survey, Homeless Persons Memorial Day, and HCH day.  Participation in two annual face-to-face meetings, one at the NHCHC national conference and one in October in Nashville, Tennessee (scholarship for the national conference is guaranteed for steering committee members)  Participation in at least one of the other committees of the National Health Care for the Homeless Council  Keep website, by-laws, and CAB manual up-to-date (with support from Council staff)  Support the work of the regional representatives who are tasked with establishing and maintaining contact with CABs around the country</p><p>Chairperson:  Presides over all meetings of NCAB steering committee  Establishes committees and work groups as necessary to accomplish the work as outlined in the NCAB work plan (available upon request)  Serves as a member of the Board of Directors of the National Health Care for the Homeless Council  Other duties as assigned</p><p>Co-Chair:  Presides over meetings in the event that the Chairperson is unavailable  Other duties as assigned</p><p>Members at large  Report on consumer involvement in the committees  Keep executive committee informed of work done in committees  Identify needs of NCAB membership and report those to the rest of the steering committee  Other duties as assigned</p>