2011-2012 Volunteer Application

 If you are interested in serving on a committee, you must submit this form by April 8, 2011.  Applications received after April 8 will be considered for other opportunities only. 

About You  
   
   
     
    
    
    
   
   
   
   
   
Country  
   
   
   
Gender (optional)   
   
   
   
About Your Institution    
   
Region  
Institution Type  
   
   
About Your Interests and Experience    
   
   
   
   
Positions of Interest
(Ctrl + Click to select all that apply) 
 
 
Topics of Interest
(Ctrl + Click to select all that apply) 

 
Can you commit to a full Term of Service?  
Your conference plans  
   
   
About Your Volunteer Work So Far    
   
Have you ever:
(Ctrl + Click to select all that apply) 
 
   
Synopsis of your activities (1000 characters max)   
At the national level    
   
At the regional level
 
   
   
At the state level
 
   
   
   
Agreement   I have read and understand:
   Committee Selection Process 
   Term of Appointments 
   Meetings and Travel Expense Policy