Langdon Prairie Health Association Membership Information

  • Membership in the LPH Association is open to any individual who is 18 years of age or older and living in LPH’s service area
  • Once the Association receives a completed application from a qualified individual, the individual is a member of the Association
  • Membership is good until the individual no longer meets the qualifications for membership
  • To vote at LPH’s Annual Meeting, a membership application must be received prior to the meeting
  • For nominations, please fill out the two documents below and the form below:

Membership Enrollment Form Submission Data

  • To apply to be a member of the Langdon Prairie Health (LPH) Board of Trustees, you must complete this form and submit it with a statement of intent, which includes goals and hopes for your term.
  • Please send your completed form and statement of intent by: Email: sarah.mikkelsen@lph.hospital

- OR -

  • Mail:   LPH, Attn: Sarah M. 909 2nd Street Langdon, ND 58249

For more information about the application process, please contact: Sarah Mikkelsen, Executive Assistant/Credentialing Manager by email at: mikkelsen@lph.hospital.

Eligibility Criteria and Conditions of Appointment a. Directors must be at least 18 years old. b. Undischarged bankrupts are ineligible to serve as directors. c. Must be a member of the Hospital Association and reside within 50 miles of LPH’s service area, per the Board of Trustees By-Laws. d. A director is expected to commit the time required to perform Board and committee duties. The minimum time commitment is likely two (2) hours per month. e. Directors must fulfill the requirements and responsibilities of their position – for example, preparing for and attending Board/committee meetings, upholding fiduciary obligations and working cooperatively and respectfully with other Board members. Directors must comply with legislation governing the hospital, its By Laws and policies, and all other applicable rules. f. Directors must sign a declaration confirming their agreement to adhere to their fiduciary duties and Board and corporate policies.
Conflict of Interest Disclosure Statement: Directors must avoid conflicts between their self interest and their duty to the hospital. In the space below, please identify any relationship with any organization or individual(s), including employees of LPH, that may create a conflict of interest, or the appearance of a conflict of interest, by virtue of being appointed to the Board.
Knowledge, Skills, and Experience
Declaration By submitting this application, I declare the following: a. I meet the eligibility criteria and accept the conditions of appointment set out above. b. I have read and agree to comply with the following: i. Board of Trustees Job Description ii. Board Code of Conduct iii. Conflict of Interest policy c. I certify that the information in this application and in my resume or biographical sketch is true.