WYHIMA Candidate Bio Submission Form

Candidate for(Required)

Please complete the demographic information below.

Name(Required)

First Last

Credentials

AHIMA ID(Required)

Address(Required)

Street Address City State Zipcode

Email(Required)

Phone(Required)

If desired, please upload your photo.

Max. file size: 256 MB.

Current Employment

Job Title Company Name

Previous Positions

Provide job title and company name in reverse chronological sequence of positions held the last 10 years.

Show degrees earned, dates, names of college or university.

AHIMA Activities

WYHIMA Activities

Other Qualifications / Training / Experience:

List any additional information that would be of value or assist in supporting your candidacy.