Biography Form

Manchester Memorial Hospital Corporator Resources

Biography Form

Manchester Memorial Hospital Corporators

Thank you for your interest in the Manchester Memorial Hospital Corporators. Our Corporators represent us throughout the Greater Manchester Region and beyond. In turn, they inform hospital leadership of the questions, concerns, and compliments of the many people we serve each year.

If you are interested in becoming a Corporator, please fill out the form below and a member of our Philanthropy Team will be in touch. If you have any questions, please contact Greg Latz at Gregory.Latz@hhchealth.org.

Contact Information

Name
Permanent Residence Address
Please direct correspondence to my:

Family Contact Information

Spouse/Partner Name

Networking Information | Hartford HealthCare Connection

Have you or a member of your family been a patient at Manchester Memorial Hospital or another Hartford HealthCare entity?
Have you or a member of your family been a volunteer at Manchester Memorial Hospital or another Hartford HealthCare entity?
Corporator Opportunities and Areas of Interest
Are you attaching a resume of other document to this form?
If yes, please upload your file using the submission tool below. If you are not, but you still want to submit a file, please contact us at MMHPhilanthropy@hhchealth.org so we can assist you.

Document or Image Submission

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    You can use this tool to upload any documents or files. If you encounter difficulties with the tool, please contact us at MMHPhilanthropy@hhchealth.org so we may assist you.

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