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 NominationsCommittee@ABIH.org.  If you have any questions, please contact the ABIH office at (517) 321-2638 or email NominationsCommittee@ABIH.org. 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?

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