Governance Fellowship Application

Class XXIII/2026-2027 Application

Thank you for your interest in applying for the MHA Excellence in Governance Fellowship. If you need assistance as you complete this application, please contact Erin Steward at the MHA or (517) 282-5639.

COMPLETED APPLICATION INFORMATION

A completed application includes:

1. Your answers to sections I - II of this application
2. A signed letter of support from your hospital chief executive officer

SUBMITTING APPLICATIONS

Completed applications and required materials should be submitted by August 28, 2026. Applications may be submitted using the electronic form below, with additional required materials emailed to esteward@mha.org. Alternatively, the application form may be completed and emailed or mailed with supporting materials to:

     MHA Excellence in Governance Fellowship
     MHA Health & Hospital Association
     2112 University Park Dr., Okemos, MI 48864

SECTION I: APPLICANT INFORMATION

Applicant Name(Required)

First Last

Name preferred in informal setting

Board on which the applicant serves

Hospital/Healthcare Organization

Address

Street Address City ZIP Code

Chief Executive Officer

CEO Phone

CEO Email

Name of CEO Assistant

CEO Assistant Email

Tuition invoice should be sent to

Applicant Personal Data

Professional (work) Title

Employer

Preferred Address (home or work)

Street Address City State ZIP Code

Best Phone Number to Contact

Best Email to Contact

(Please use the email address where you will want all fellowship correspondence to be delivered.)

Spouse/Partner Name (if applicable)

SECTION II: EXPERIENCE

1. Please submit a current resume or curriculum vitae. 2. Board experience

Number of years on current hospital/healthcare organization board

Hospital/healthcare organization board committees on which you have served or are now serving

Other civic/government board activities

SECTION III: LETTER OF ORGANIZATIONAL SUPPORT

You are required to submit a letter of support from the healthcare organization’s chief executive officer indicating organizational support and commitment (time and resources) for your participation in the fellowship program.

The MHA Health Foundation is the nonprofit section of the Michigan Health & Hospital Association, established to support hospitals and their community partners in improving the health of individuals and communities throughout Michigan.

Copyright ©2001-2026 Michigan Health & Hospital Association and MHA Health Foundation. All rights reserved. No part of this piece or the MHA Excellence in Governance Fellowship program may be used or reproduced in any manner without written permission of the MHA Health Foundation.

Note: Forms will not be accepted if they include URLs.