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Nomination Form
Hiromi Hiraoka
2026-09-01T17:47:58+00:00
Meals on Wheels California Board Member Nomination Form 2026
Name
(Required)
First
Last
Organization
(Required)
Job Title
(Required)
Organization Address
(Required)
Street Address
Address Line 2
City
ZIP / Postal Code
Phone
(Required)
Country
Phone Number
Email
(Required)
Please list all your qualifications to be a member of the Meals on Wheels California (MOWCA) Board of Directors (please note that all such information may be made public to MOWCA members.
1. Indicate which qualification category you are applying for:
(Required)
a. I hold a key leadership position at a Meals on Wheels program in CA
b. I am in a leadership position in an affiliated field
Are you the Executive Director of your organization
(Required)
Yes
No
If no, do you have the approval of the ED of your organization for your application to be a MOWCA board member
(Required)
Yes
No
Please list your job title and the affiliated field
(Required)
2. List current and past involvement with MOWCA and/or working in the senior nutrition field in California.
(Required)
3. Please explain your reasons for seeking a Board position.
(Required)
4. What do you see as the key issues and concerns facing home delivered meals/senior nutrition programs?
(Required)
5. Please describe any additional qualifications for service.
6. You are required to provide a recent picture of yourself which, along with your candidate information, will be made available to MOWCA membership should you be among the Nominating Committee's recommended slate of candidates. As such, please attach a picture in electronic format (jpg, png, etc.) along with your application.
Max. file size: 10 MB.
7. By signing below, you hereby acknowledge and agree: a) to conscientiously fulfill the responsibilities and obligations related to service as a Director or Officer of Meals on Wheels California's Board and to maintain high ethical standards; b) to permit MOWCA to publish any photographs or images of you and any and all materials provided by you in response to this Nomination Form; c) that the responses provided by you are accurate to the best of your knowledge; and d) that photographs and all other materials provided by you to the MOWCA become the property of MOWCA and may be used by the MOWCA without further permission.
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