ASA Generations Editorial Advisory Board Application

Tell us about yourself

Thank you for your interest in applying for service on the Generations Editorial Advisory Board.

Note: ASA membership is required in order to serve on this Advisory Board. If you are not yet an ASA member or your membership has lapsed, visit www.asaging.org/join to become a member or contact Jutka Mandoki at 415-974-9630.

Generations brings together the latest in research, practice, and policy on a single key topic in aging, and uses an Editorial Advisory Board—distinguished academics, researchers, practice-oriented professionals, and policy experts from different areas in the field of aging that are instrumental in identifying topics for each issue.

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

Name: *

Company:

Address: *

Address 2: *

City/Town: *

State: *

ZIP: *

ASA MEMBER ID: *

Email Address: *

Phone Number: *

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* 2. Which of the statements below best describes you?

I am a recent graduate or early-stage professional looking to enhance my skills

I am a professional on a rising leadership track looking to contribute my knowledge and expand my leadership skill set

I am an experienced professional looking to contribute my skills where they are needed

I am a previous ASA volunteer leader (please list other ASA volunteer service in the space below)

Past volunteer service:

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* 3. If applicable, please give the name and e-mail address of the individual who has nominated you to apply for the Generations Editorial Advisory Committee.

Nominator Name:

Email address:

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* 4. By checking the box below, I understand that the term for which I am applying will begin in March 2016 and conclude March 2018.

I understand the term commitment and length.

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* 5. Responsibilities of Generations Editorial Advisory Board Members:

-To participate in two (2) one-day, in-person meetings per year (these are held in the Spring and Fall, at the Aging in America Conference and the Gerontological Society of America conference, respectively).

-To participate in a group process for Generations issue theme selection

-To act as a contact for recruiting prospective authors and/or guest editors

-To contribute articles (optional)

-To promote the publication

-I agree to meet these requirements if chosen to serve on this Board:

Yes

Other (please specify)

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* 6. Please explain in a short essay (up to 2000 characters) why you wish to serve on the Generations Editorial Advisory Board, and what you feel you can specifically contribute to the Board. Please also describe your specific domain knowledge (examples of domains/disciplines would be within the healthcare system; in medical services delivery; in policy/advocacy; in caregiving; in philanthropy; in legal; in clinical knowledge; in business and consumer marketplaces; in federal/state government, etc.)

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* 7. Please give an assessment of your skills at working with others in a committee structure and process. The rating system is as follows: 1 = I do not have this competency; 2 = I have this competency to a limited degree; 3 = I am effective in this competency; 4 = I excel in this competency.

	1-Do not have	2-Limited	3-Effective	4-Excel
Verbal communication skills	Verbal communication skills 1-Do not have	Verbal communication skills 2-Limited	Verbal communication skills 3-Effective	Verbal communication skills 4-Excel
Written communication skills	Written communication skills 1-Do not have	Written communication skills 2-Limited	Written communication skills 3-Effective	Written communication skills 4-Excel
Educational programming	Educational programming 1-Do not have	Educational programming 2-Limited	Educational programming 3-Effective	Educational programming 4-Excel
Working with diverse populations	Working with diverse populations 1-Do not have	Working with diverse populations 2-Limited	Working with diverse populations 3-Effective	Working with diverse populations 4-Excel
Outreach	Outreach 1-Do not have	Outreach 2-Limited	Outreach 3-Effective	Outreach 4-Excel
Marketing	Marketing 1-Do not have	Marketing 2-Limited	Marketing 3-Effective	Marketing 4-Excel
Conflict resolution	Conflict resolution 1-Do not have	Conflict resolution 2-Limited	Conflict resolution 3-Effective	Conflict resolution 4-Excel
Consensus building	Consensus building 1-Do not have	Consensus building 2-Limited	Consensus building 3-Effective	Consensus building 4-Excel
Working in teams	Working in teams 1-Do not have	Working in teams 2-Limited	Working in teams 3-Effective	Working in teams 4-Excel
Volunteer/staff relations	Volunteer/staff relations 1-Do not have	Volunteer/staff relations 2-Limited	Volunteer/staff relations 3-Effective	Volunteer/staff relations 4-Excel