DOH Membership Application

Metropolitan Washington Regional HIV Health Services Planning Council

Application for Membership

For Information or Assistance Please Contact

Planning Councill Co-ordinator
DC HIV/AIDS Administration

899 North Capital Street, NE Fouth Floor
Washington, DC 20002
202-671-4900
 

Instructions

The Membership Committee is accepting applications for appointment of members to the Metropolitan Washington Regional HIV Health Services Planning Council. Please type or print responses to all questions below. Attach additional sheets of paper if more space is required for answers. If you have questions concerning this form, please contact:

Planning Councill Co-ordinator
DC HIV/AIDS Administration

899 North Capital Street, NE Fouth Floor
Washington, DC 20002
202-671-4900

SECTION A: Membership Information
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