MEMBERSHIP APPLICATION REQUEST Survey

Membership Type:(Required.)

Organization

Individual

Please provide the following information for the individual who will be acting as the PRIMARY REPRESENTATIVE.

Name and Title

Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

If applying as an organization, please provide the following information for the individual who will be acting as the ALTERNATE REPRESENTATIVE.

Name and Title

Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

The organization/individual is interested in the review/revision of the ASC Z97 as:(Required.)

A voting member of the Committee

A non-voting observer (shall be advised of committee activities, may attend meetings, and may submit comments for consideration

Other (please specify)

ASC guidelines require that committee members and applicants indicate their direct and material interest in the committee's work as well as their qualifications and willingness to participate actively. Please indicate the level of activity you envision on your part by checking the appropriate box(es).(Required.)

Will regularly attend meetings

Will actively participate in subgroups

Will review and comment on all documents

Will respond to ballots in a timely manner

Please provide a brief statement of your, or your organization's, qualifications for membership.(Required.)

MEMBERSHIP APPLICATION REQUEST

ASC Z97 Committee