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* 1. First Name

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* 2. Last Name

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* 3. Email address

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* 4. Phone number

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* 5. Company Name

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* 6. Title

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* 7. Address

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* 8. City

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* 9. Postal code

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* 10. Have you also applied to be a Volunteer Regional Ambassador?

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* 11. Which Region would you be interested in working with?

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* 12. Which of the following supply chain functions reflect your current role?

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* 13. By signing this form, I verify that the information supplied is true and accurate. (Please type your name in the box)

Privacy Statement

The personal information on this form is being collected for the purposes of recruiting and selecting volunteers wishing to work at SCMAO. The information may also be required for evaluation purposes.

I understand that submitting this volunteer application form does not automatically guarantee me a volunteer position with SCMAO but that there is an interview and selection process and participation in training/volunteer orientation for each selected volunteer role. I also agree to release and hold harmless the staff, management and Board of Directors of SCMAO from any liability for information disclosure or injury while working as a volunteer.  I hereby understand and agree that I am not a paid employee and must abide by the organization’s rules, regulations and policies while working as a volunteer for SCMAO.
Thank you for taking the time to express your interest in SCMAO and the role of Regional Advisor.

We will reach out to you in late March to let you know about next steps.

If you have any questions, please contact Judith Campbell at 1-877-726-6968 x 2154.
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