Board of Directors Interest Form Board of Directors Interest Form Personal Information First Name Last Name Address Phone Email Current Employer / Organization Title / Position Qualifications & Interest Why are you interested in serving on Premier’s Board of Directors? Relevant professional or community experience Skills you would bring to the Board (governance, finance, legal, healthcare, fundraising, etc.) Other boards you currently or previously served on Signature Signature (type full name) Date 🖨️ Print This Form 📄 Download PDF Version Need help? If you have difficulty using this form, please call (352) 518-2000 for assistance. Phone requests may experience longer wait times than using the form above.