ConnexFM Healthcare Council Interest Form

Healthcare Council Applications are currently being accepted for the commitment term starting January 1-December 31, 2023. There are (15) seats open on the council based on experience and membership type. There are several opportunities outside of the council available to applicants including task forces dedicated to health resource development, virtual/live/hybrid events, and education.

ConnexFM is looking for professionals that currently have experience in facilities management within the healthcare industry. Please provide as much information as possible in the application below.

Full Name: *
Email: *
LinkedIn URL: *
Organization Name:
Phone Number:
Certifications or Relevant Credentials: *
Years of Healthcare Industry Experience: *
Years of FM Industry Experience: *
Please briefly describe any relevant experience and your reason for applying:: *
(SUPPLIERS ONLY) 3 References are required to complete your application:

Please provide (3) references relating to your above experience. For each reference include Name, Email, Phone, Company, Nature of Reference (client, etc.).

Full Name: *
Title: *
Email: *
Phone Number: *
LinkedIn URL: *
Current Employer:
How long you have been with your current company?: *
Where did you work before this company?: *
How long have you or your organization been a CONNEX Member?: *
How many years of work experience do you have in the Healthcare industry?: *
How many years of work experience do you have in the facilities management industry?: *
Why are you interested in joining this Council?: *
What do you feel you can contribute to this Council?:
Do you possess any certifications or relevant credentials that you’d like to share?: *
(SUPPLIERS ONLY) 3 References are required to complete your application:

Please provide (3) references relating to your above experience. For each reference include Name, Email, Phone, Company, Nature of Reference (client, etc.).