Application Form

For your application to be considered you must: (1) complete the information requested on this form to the best of your ability and (2) email your resume or curriculum vitae to  If you have any questions, please contact the ABIH office at (517) 321-2638 or email Thank you.

* 1. What type of ABIH Board position are you applying for?

* 2. Contact Information

* 3. What is the time zone for this address?

* 4. Work Information

* 5. Describe your primary job responsibilities for your current position.

* 6. About how long have you been in your current position?

* 7. Type the number of years of work experience in each of the following areas:

* 8. Bachelor's Degree

* 9. Master's Degree (if applicable)

* 10. Doctoral Degree (if applicable)

* 11. List your professional certifications and the year achieved.

* 12. Describe any professional leadership positions and achievements
(e.g., AIHA local sections, national level committees, certification boards, mentorship, etc.)

* 13. Describe any community leadership positions and achievements.

* 14. What do you believe are the major challenges and opportunities that ABIH will face in the next four years?

* 15. What contributions do you believe you could make as a member of the ABIH Board of Directors to address these challenges or opportunities?

* 16. Are you willing to attend three (3) weekend Board meetings per year and participate in 9 monthly conference calls?

* 17. Are you willing and able to serve a four (4) year term of office?

* 18. Do you have your employer’s approval to make this time commitment?

* 19. Do you have any business, professional, or personal activities that could constitute a conflict of interest with the work of the American Board of Industrial Hygiene?