Please complete the below form to express your interest in joining a Sub-Committee on WIRV.

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* 1. Name

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* 2. Occupation

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* 3. Position/Title

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* 4. Area(s) of Practice

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* 5. Company Name

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* 6. Postal Address

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* 7. Email Address

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* 8. Phone Number

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* 9. How many Sub-Committees would you like to join? (Note - you will submit your preferences in the next section)

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* 10. Which Sub-Committee(s) would you like to join in 2020? Please rank your preferences below, with your first preference at the top, second preference below that, and so on.

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* 11. I confirm that:

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I will attend at least 50% of all Sub-Committee meetings held during the year; and

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* 12. I confirm that:

  Yes No
I am a current WIRV member of good standing

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* 13. If I am accepted to a subcommittee of WIRV, I will familiarise myself with the WIRV Constitution and Charter of Rights and I will comply with my responsibilities and obligations as set out therein.

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