certification application

PHMA CERTIFICATION PROGRAM APPLICATION FORMSERVICE ACTIVITIES (continued)n Member of Housing Community Organization (10 points):Organization: ____________________________ From: (Mo/Yr) __________ To: (Mo/Yr) ____________Organization: ____________________________ From: (Mo/Yr) __________ To: (Mo/Yr) ____________n Published article in Defense Communities or similar (3 points).Title of Article: ________________________________________________ Date: (Mo/Yr) ____________Title of Article: ________________________________________________ Date: (Mo/Yr) ____________n Other Housing service activity or accomplishment (5 points): (Please describe below)n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________n ACTIVITY: ___________________________________________________________________________Description: ______________________________________________________ Year: ____________PHMA Cert Form 03/2009 13