Michigan Health & Hospital Association
2011 Michigan Harvest Gathering
Food Drive Project Team Leader Form

To ensure that we are contacting those who will be involved in coordinating the food drive in your facility, please designate a food drive project team leader. This appointment should be made and/or approved by the organization's CEO, with the consent of the designated project team leader. Materials and campaign updates will be sent directly to the project team leader.

Yes, this organization will participate in the MHA Michigan Harvest Gathering
No, we will not participate, because:

CEO's Name:
Title:
Organization:
Address:
Address (cont.):
City:
State:
ZIP Code:

Project Team Leader: (suggested individuals include last year's project leader, hospital auxiliary president, director of volunteer services, community or public relations director, etc.)

Name:
Title:
Address:
Address (cont.):
City:
State:
ZIP Code:
Phone:
Fax:
E-mail:	*Required

Questions about the Michigan Harvest Gathering and/or the responsibilities of a project leader may be directed to Paige Hathaway at the MHA.