Interested in a subcommittee or other ways to volunteer?  Answer these questions below.

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* 1. Let's learn a little more about you:

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* 2. Which of the following best describes your current job level?

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* 3. What is the highest level of school that you have completed?

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* 4. Are you a nurse?

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* 5. Which committee(s) are you interested in?  Please rank your top choices (1, 2, 3, etc.) Leave a 0 if not interested.

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* 6. Are you interested in one of the following roles: Co-Lead (2 available per committee) or Secretary?  Please indicate below:

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* 7. Please describe (in 200 words or less) your experience for the role you have indicated. If only interested in a volunteer role, OK to leave blank.

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* 8. Please copy and paste your LinkedIn profile:

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* 9. Do you have up to 4 hours a month to donate to work on behalf of the Commission?

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* 10. Are you interested in writing articles/blog posts for the Commission?

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* 11. Do you have any other comments, questions, or concerns?

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* 12. We will be looking for fundraising for the Commission.  Would you be willing to reach out to your institution, organization, or affiliated group to see if they would be interested in supporting the work of the Commission?  If yes, please indicate the organization name below.

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