America’s Essential Hospitals Government Relations Academy 2022 Participant Application

The 2022 Government Relations Academy is for member hospital professionals whose responsibilities include advocating for their hospital or health system, promoting public policies, and building relationships that benefit their organization. Each 2022 Government Relations Academy application must include information for the hospital or health system government relations staff member applying for the program and a designated communications staff member. The designated communications staff member is required to attend the second session of the Government Relations Academy in June 2022 at VITAL.

Electronic Application Deadline: Friday, Dec. 10, 2021.

Application instructions and tips: Please adhere to the word limits where noted. We suggest you complete this survey without interruption. If this survey is inactive for over 180 minutes, it will time-out and your previous answers will be lost. If you have any questions regarding your submission, please contact Christina Fagnano at cfagnano@essentialhospitals.org.

Name of Hospital/System: *

First name: *

Last name: *

Designation (Mr., Ms., Dr., etc.): *

Credential(s):

Title: *

Email address: *

Phone number: *

CEO name: *

Confirm CEO approval of this submission *

Confirm

Session 2 of the GR Academy focuses on the relationship between advocacy and communications and how to effectively tell your story to a variety of audiences. Class participants are asked to bring a colleague from their hospital's communications team to this session at VITAL 2022.

Communications staff first name: *

Communications staff last name: *

Confirm communications staff approval of this submission: *

Confirm

Communications staff designation (Mr., Ms., Dr., etc): *

Communications staff title: *

Communications staff credential(s):

Communications staff email address: *

Communications staff phone number: *

Short answer questions:

1. Limit of 300 words. Provide a one to two paragraph biography of your work related to a government relations or a government relations-type role. *

0/300 words

2. Limit of 400 words. Describe what skills and insights you hope to gain from participating in this program. *

0/400 words

3. Limit of 400 words. How will your institution benefit from your participation in this program? *

0/400 words

4. Limit of 400 words. Describe the challenges that your organization faces in its advocacy and policy work. *

0/400 words