ICE Volunteer Interest Survey

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* 1. Name/Credentials

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* 2. Title

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* 3. Member Organization (no acronyms)

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* 4. Email

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* 5. Please check to confirm that your information in the ICE member profile is correct and update as needed.

The information is correct

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* 6. Typically, committees meet monthly via conference call with assignments for members in between. I have noted my preferences below: (select up to three; use 1, 2, and 3 to prioritize; 1-highest interest)

**Two year commitment

	1	2	3
Annual Conference Program Committee**	Annual Conference Program Committee** 1	Annual Conference Program Committee** 2	Annual Conference Program Committee** 3
Education Committee	Education Committee 1	Education Committee 2	Education Committee 3
Government Affairs Committee	Government Affairs Committee 1	Government Affairs Committee 2	Government Affairs Committee 3
Membership Outreach Committee	Membership Outreach Committee 1	Membership Outreach Committee 2	Membership Outreach Committee 3
Research and Development Committee**	Research and Development Committee** 1	Research and Development Committee** 2	Research and Development Committee** 3
Research and Development Fundraising Committee	Research and Development Fundraising Committee 1	Research and Development Fundraising Committee 2	Research and Development Fundraising Committee 3
Publications and Editorial Committee	Publications and Editorial Committee 1	Publications and Editorial Committee 2	Publications and Editorial Committee 3
International Credentialing Task Force	International Credentialing Task Force 1	International Credentialing Task Force 2	International Credentialing Task Force 3
External Stakeholders Working Group	External Stakeholders Working Group 1	External Stakeholders Working Group 2	External Stakeholders Working Group 3
Public Member Resource Development Task Force	Public Member Resource Development Task Force 1	Public Member Resource Development Task Force 2	Public Member Resource Development Task Force 3
Diversity, Equity, & Inclusion Task Force	Diversity, Equity, & Inclusion Task Force 1	Diversity, Equity, & Inclusion Task Force 2	Diversity, Equity, & Inclusion Task Force 3
Micro-Volunteer Opportunities	Micro-Volunteer Opportunities 1	Micro-Volunteer Opportunities 2	Micro-Volunteer Opportunities 3

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* 7. What does volunteering for ICE mean to you? Please provide a brief statement.

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* 8. The following information is optional but will further assist ICE in its efforts to compose committees that incorporate diversity and broad representation.

	What is your preferred gender?	What is your ethnic background?	What is your age range?
Demographic Information	Demographic Information What is your preferred gender? menu	Demographic Information What is your ethnic background? menu	Demographic Information What is your age range? menu

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* 9. Commitment:

I understand that ICE does not fund any expenses for committee activities, other than conference calls arranged by the committee chair and required travel for Program committee in-person meetings. I also understand that I must be a current ICE member and a member throughout 2021 to participate on a committee.

Yes