NASAC BOD Rep Student Nomination Form
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SETAC North America Student Advisory Council (NASAC)Student Nomination Form for the 2012-2013 Vice Chair and 2013-2014 Chair of the SETAC North America Student Advisory Council and Student Representative to the SETAC North America Board of Directors

This position requires 2 years of service to NASAC and the SETAC Board of Directors - the first year (2012-2013) as Vice Chair and the second year (2013-2014) as Chair. Only students from North America will be considered for the position.

Only complete applications will be considered

Application deadline: October 12, 2012

1. Personal Information

Personal Information Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Country:
Email Address:
Phone Number:

2. Student Information

Student Information University
Graduate Program or Department
Degree (e.g., MS, PhD, etc.
Estimated month/year of graduation

3. SETAC Membership Information

SETAC Membership Information SETAC Membership Number
How long have you been a member?

4. Are you a member of a SETAC North America Regional Chapter?

Are you a member of a SETAC North America Regional Chapter? Yes

5. If yes, which Regional Chapter do you belong to?

If yes, which Regional Chapter do you belong to?

6. Please describe your involvement in SETAC North America (e.g., on a national level, participation on committees, etc.) and/or SETAC North America Regional Chapter activities.

Please describe your involvement in SETAC North America (e.g., on a national level, participation on committees, etc.) and/or SETAC North America Regional Chapter activities.

7. Please describe your interest in serving as the SETAC North America Student Advisory Council (NASAC) Chair as well as on the SETAC North America Board of Directors.

Please describe your interest in serving as the SETAC North America Student Advisory Council (NASAC) Chair as well as on the SETAC North America Board of Directors.

NASAC BOD Rep Student Nomination FormExit this survey

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NASAC BOD Rep Student Nomination Form
Exit this survey