2020 CALL FOR VOLUNTEERS

Please indicate your interest in serving on any of the following committees. When there is a committee opening, first consideration is given to those who have sent in this form. We will do our best to accommodate your interests. Keep in mind that the Awards and Nominations Committee must consider both geographic and speciality representation on each committee when selecting nominees.

Question Title

* 1. Contact Information

Name *

State/Province *

Email Address

Phone Number

Question Title

* 2. Please complete all fields below for each committee:

	I have served on this committee in the past	I now serve on this committee	I would like to serve on this committee when there is an opening
Accreditation of Centres	Accreditation of Centres I have served on this committee in the past	Accreditation of Centres I now serve on this committee	Accreditation of Centres I would like to serve on this committee when there is an opening
Awards and Nominations	Awards and Nominations I have served on this committee in the past	Awards and Nominations I now serve on this committee	Awards and Nominations I would like to serve on this committee when there is an opening
Clinical Practice	Clinical Practice I have served on this committee in the past	Clinical Practice I now serve on this committee	Clinical Practice I would like to serve on this committee when there is an opening
Credentials	Credentials I have served on this committee in the past	Credentials I now serve on this committee	Credentials I would like to serve on this committee when there is an opening
Education, Ethics & Public Policy (E2P2)	Education, Ethics & Public Policy (E2P2) I have served on this committee in the past	Education, Ethics & Public Policy (E2P2) I now serve on this committee	Education, Ethics & Public Policy (E2P2) I would like to serve on this committee when there is an opening
Examinations	Examinations I have served on this committee in the past	Examinations I now serve on this committee	Examinations I would like to serve on this committee when there is an opening
Examinations Advisory	Examinations Advisory I have served on this committee in the past	Examinations Advisory I now serve on this committee	Examinations Advisory I would like to serve on this committee when there is an opening
Laboratory Practice	Laboratory Practice I have served on this committee in the past	Laboratory Practice I now serve on this committee	Laboratory Practice I would like to serve on this committee when there is an opening
Metabolics	Metabolics I have served on this committee in the past	Metabolics I now serve on this committee	Metabolics I would like to serve on this committee when there is an opening
Policy & By-laws	Policy & By-laws I have served on this committee in the past	Policy & By-laws I now serve on this committee	Policy & By-laws I would like to serve on this committee when there is an opening
Training	Training I have served on this committee in the past	Training I now serve on this committee	Training I would like to serve on this committee when there is an opening
Scientific Program	Scientific Program I have served on this committee in the past	Scientific Program I now serve on this committee	Scientific Program I would like to serve on this committee when there is an opening

Question Title

* 3. CCMG Certification

Laboratory Biochemical Genetics

Clinical Biochemical Genetics

Clinical Genetics

Cytogenetics

Molecular Genetics

Year(s) of Certification

Question Title

* 4. Language(s) Spoken

English

French

Other: