Committee Application 2010-2011 Thank you for your interest in applying for a committee position. The volunteer leadership, along with the Central Office, are crucial to the success of our organization. Please complete the following application by February 26 (Or March 18 for affiliate members). View the committees listed on the ASSH website and review the charges carefully. Members are expected to commit to the charges as listed. Question Title * 1. I have read the description of the position(s) for which I am applying, and I appreciate the responsibilities associated with such position(s). I hereby represent that, if appointed to such position(s), I will commit myself to the position(s) and will fulfill such responsibilities to the best of my ability. Agree Disagree Question Title * 2. Please enter your full name and email address. Full Name: Email: Please indicate which committee(s) you would most like to serve on, ranking your choices 1,2, and 3. Please describe experience and skills in the spaces provided. Question Title * 3. Committee 1st Choice: 1. Are you CURRENTLY serving on this committee (Y/N)? Question Title * 4. Please describe any positions and projects you have completed that are relevant to the this Committee Position. Question Title * 5. What skills would you bring to this position? Question Title * 6. Committee 2nd Choice: 2. Are you CURRENTLY serving on this committee (Y/N)? Question Title * 7. Please describe any positions and projects you have completed that are relevant to the this Committee Position. Question Title * 8. Committee 3rd Choice: 3. Are you CURRENTLY serving on this committee (Y/N)? Question Title * 9. Please describe any positions and projects you have completed that are relevant to the this Committee Position. Question Title * 10. What skills would you bring to this position? Question Title * 11. If there are no vacancies on the committee(s) you selected, would you be willing to serve on any committee? Yes No Thank you for applying for a committee position.This window will close when you click "Done." Done >>