Membership Application




EMPLOYMENT: The candidate is employed by an organization whose primary mission is the provision or financing of health care service, the support of health care service providers, or education of health care providers.


POSITION: The candidate holds an executive level position or a position of equal authority and responsibility (this does not include mid-management position), or a related position which provides the experience to qualify the candidate for an executive level position in the future.


EDUCATION & EXPERIENCE: The candidate’s formal education, coupled with her work experience and history in the health care field, is commensurate with that of a professional executive. Minimum of 5 years experience in healthcare related field required.


COMMITMENT: The candidate is committed to a career in the health care industry as demonstrated by an acceptable combination of education, experience, position, employment, and achievement.


PROFESSIONALISM: The candidate’s high professional caliber is well evidenced by her articulate communication, polished presentation and command of situational needs.


SUPPORT: The candidate’s history of participation in other activities or organization is indicative of her willingness to share her time and talents to facilitate the attainment of WHEN’s objectives, as established by the by-laws of the organization.


MENTORSHIP: The candidate has demonstrated not only her support of women in executive positions, but also her ability to inspire and influence other women to ascent to such positions.





Candidate’s Name:
Mailing Address:
Work Telephone:
E-Mail Address:


What is the highest degree obtained by the candidate?

o Doctorate ______________________
o Master’s ______________________
o Other ______________________


Which of the following best describes the candidate’s position?

o Executive Level Reports to the governing body of the organization or holds one of
the top three positions. Examples: CEO, COO, CFO, Executive Director, President, and Dean.

o Senior Level Reports to the Executive Level. Examples: Faculty positions,
Assistant Administrator, Associate Administrator, Vice-President, Senior Consultant, and Partner.

o Mid Level Reports to Senior Level. Examples: Department Head, Management Consultant, and Junior Partner. Senior level preferred but if candidate is part of a large organization, they may be considered with this position.


How many years has the candidate been employed in the health care field?

o 10 years or more
o 8-10 years
o 5-8 years


The candidate’s professional career plans are to:

o Continue to pursue a career in the health care industry.
o Remain in her current position for some time but future plans are uncertain.


The candidate’s level of professionalism is:

o Appropriate for her position and level of experience.
o Well evidenced by her articulate communication, polished presentation, and command of situational needs.


The candidate will participate in WHEN:

o To the degree that her many other commitments and organizational responsibility will allow.
o As an active member and would serve well on committees and meet other responsibilities as required.


The candidate has demonstrated:

o Support of women in executive positions.
o Not only her support of women in executive positions but possesses an ability to inspire, influence, and facilitate the ascension of other women of other position.


Please include a resume or C.V. for the candidate you are sponsoring.



This candidate is nominated by:


Work Telephone:


How do you know the candidate?


How long have you known the candidate?


Are there any other members of WHEN who may know the candidate?


Please list any other information that you would like to share that would allow the WHEN Board members to understand why this candidate would make an outstanding WHEN member:


This application must be submitted directly from the sponsoring WHEN member.
Return completed application, including resume to:


Julie D. Brown, AIA
PO Box 55073
Metairie, LA 70055-5073