1.Please enter your personal information

First Name

Last Name

Home Address

Home Address 2

City/Town

State/Province

ZIP/Postal Code

Occupation 

Email Address

Phone Number

2.What are your professional credentials?

3.Why do you think you are a good fit for this Committee

4.I want to be a part of NCBC Navigation Committee because:

*5.Inside the Navigation General Committee there are 5 subcommittees. Please let us know if you are interested in sitting on any along with the general committee(Required.)

Navigation Test Development

Navigation Member Engagement/Networking

Navigation Mentorship

Navigation Award/Navigation Day

NCoBC Navigation Post Conference Planning

I am not currently interested in sitting on a subcommittee

I want more information before response: (please specify which subcommittee you want more infomation on

6.If there is anything else, you’d like to share with us before completing this form please do so here: