Application for individuals interested in joining SBA's Research Advisory Committee.

The Research Advisory Council provides resources and guidance to the research efforts of the Spina Bifida Association. Members of the Advisory Council share their gifts in service to our mission by providing our organization with their expertise; their diverse knowledge of constituent perspectives; their connections to local, national or international resources, colleagues or peers; their philanthropic support or other forms of needed assistance.

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* 1. Name:

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* 2. Gender:

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* 3. Home Address

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* 4. What is your relationship to Spina Bifida? Check all that apply.

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* 5. What is the highest level of education you have completed?

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* 6. What is your current employment status?

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* 7. Have you ever served as a member of an advisory board, committee, or board of directors for a non-profit or for profit organization?

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* 8. Do you have experience identifying research funding opportunities?

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* 9. Why do you want to join SBA's Research Advisory Committee?

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* 10. What qualities or experience would you bring to this committee?

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* 11. Have you read and familiarized yourself with the Research Advisory Committee Charge before submitting this application?

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* 12. Electronic Signature (print name)

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* 13. Today's date

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