American Society on Aging Board Application - 2023-2025

Introduction

Thank you for your interest in joining the board of directors of the American Society on Aging (ASA). This application will take about 15-20 minutes to complete. Your responses will be shared only with key staff at ASA and with members of the board's Nominating Task Force.

Once you complete the online application, you must email your CV/resume to Jacki Bennett, Chief of Staff, at jbennett@asaging.org by September 30, 2022. We will be in contact soon after this date.

Question Title

* 1. Please provide your name and contact information, including your individual ASA Member ID.

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

ZIP:

Country:

Email Address:

Phone Number:

American Society on Aging Board Application - 2023-2025

Introduction

Question Title

* 1. Please provide your name and contact information, including your individual ASA Member ID.

Question Title

* 2. Organizational Affiliation/Company/Retired:

Question Title

* 3. ASA Membership ID Number: