Thank you for your interest in ACT leadership! Please respond to these questions as thoughtfully and completely as possible.

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* 1. Your name:

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* 2. Degree and Year:

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* 3. Preferred way to reach you (e-mail or phone number):

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* 4. How have you been involved with ACT?

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* 5. Which position are you interested in? If you are interested in more than one, please rank your choices.

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* 6. What skills and attributes do you bring to this position that make you a fabulous candidate?

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* 7. The success of ACT depends on a management board and committees of people who are enthusiastic, committed to the ACT mission and willing to roll up their sleeves and do the operational work needed. Please tell us anything else you’d like us to know about you, your work ethic, or your disposition that would help us in creating the best ACT board and committees.

Thank you for your interest in helping to lead ACT! We'll follow-up with you soon!

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