Board of Directors

Welcome to the Council for Relationships Board of Directors! Please complete this form with your contact information to ensure that you’re kept up to date. Board members are listed on the Leadership page of our website.

If there are any questions, please email Co-Interim CEOs, Howard Cohen and Emma Steiner, or Marketing Director, Jessica Willingham.

Name
What is your full name, as you would like it to appear on Board listings? (Board member names are listed as preferred; some formally, some informally).
First Last
Post Nominal Initials
PhD, MD, etc.
What is your primary affiliation?
What is your professional title?
What other organizations are you affiliated with?
If married, what is your partner's name?
What is your preferred email address?*
What is your preferred phone number?*
The preferred phone number is your
- Cell
- Home
- Work
Is there an alternate phone number you would like us to have?
The alternate phone number is your
- Cell
- Home
- Work
Bio
Please insert a short bio of your professional background (250 words or less).
CAPTCHA
Please upload your professional headshot here
Accepted file types: jpg, png, Max. file size: 50 MB.
Name
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