2023 - 2025 Agency Board Member Application Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Company Name Question Title * 4. Company Address Question Title * 5. Country where you are based Question Title * 6. Mobile number Question Title * 7. Job title Question Title * 8. Email address Question Title * 9. Number of years in International Healthcare Market Research/Business Intelligence: Question Title * 10. Brief Career history (200 words max): Question Title * 11. Why would you like to be an Agency Member representative on the Board? Please explain why you would like your colleagues to vote for you: (max 200 words allowed) Send to EPHMRA