Please Complete All Requested Information For the Committees You Are Interested In

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100% of survey complete.

1st Vice President Rick Blair is looking for many good members that would like to serve on committees of the MSFA for the years 2017-2018.  Please complete the Survey below to provide him with your interests and contact information.

First Name:

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* 1. First Name:

Last Name:

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* 2. Last Name:

Which member company or partner organization are you affiliated with?

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* 4. Which member company or partner organization are you affiliated with?

Is your information in the current 2017-2018 directory correct?

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* 5. Is your information in the current 2017-2018 directory correct?

What is your street address?

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* 6. What is your street address?

City

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* 7. City

State

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* 8. State

Zip Code:

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* 9. Zip Code:

Email Address:

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* 10. Email Address:

Preferred Phone Number:

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* 11. Preferred Phone Number:

Secondary Phone:

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* 12. Secondary Phone:

Are you currently serving as a committee chair, co-chair, or vice chair?

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* 13. Are you currently serving as a committee chair, co-chair, or vice chair?

If "Yes" - Which Committee

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* 14. If "Yes" - Which Committee

Are you still interested in this position?

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* 15. Are you still interested in this position?

If No, who would you recommend?

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* 16. If No, who would you recommend?

Are you interested in serving as a committee chair?

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* 17. Are you interested in serving as a committee chair?

If "Yes", which Committee?

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* 18. If "Yes", which Committee?

Select all of the Committees You are Interested in Serving on!

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* 19. Select all of the Committees You are Interested in Serving on!

PRESS Done when you have answered all Questions.  Your Interest will be reported to 1st Vice President Rick Blair, and he will be in touch with you in the next few months as he prepares his Committee line-ups!

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* 20. PRESS Done when you have answered all Questions.  Your Interest will be reported to 1st Vice President Rick Blair, and he will be in touch with you in the next few months as he prepares his Committee line-ups!

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