Oregon AFSCME 2017 - Committee / Caucus Request Form

Biennial Convention - Salem Convention Center - April 28-30, 2017

The description, mission and vision of each Committee or Caucus is listed here

NOTE: The Council 75 President and Executive Board make all final decisions and not all requests may be able to be honored.

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* 1. Full Name:

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* 2. Local #:

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* 3. Best Phone Number:

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* 4. Personal Email Address:

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* 5. COMMITTEE SELECTION:
Please indicate the first choice and the second choice of committees you wish to serve on.

	1st Choice	2nd Choice
Building	Building 1st Choice	Building 2nd Choice
Diversity	Diversity 1st Choice	Diversity 2nd Choice
Good & Welfare	Good & Welfare 1st Choice	Good & Welfare 2nd Choice
Policy	Policy 1st Choice	Policy 2nd Choice
Political Action (PAC)	Political Action (PAC) 1st Choice	Political Action (PAC) 2nd Choice
Public Safety	Public Safety 1st Choice	Public Safety 2nd Choice
Scholarship	Scholarship 1st Choice	Scholarship 2nd Choice
Training	Training 1st Choice	Training 2nd Choice
Women’s	Women’s 1st Choice	Women’s 2nd Choice

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* 6. Please indicate which Caucuses you are interested in

Conservative Caucus

Environmental Caucus

Next Wave

Question Title

* 1. Full Name:

Question Title

* 2. Local #:

Question Title

* 3. Best Phone Number:

Question Title

* 4. Personal Email Address:

Question Title

* 5. COMMITTEE SELECTION: Please indicate the first choice and the second choice of committees you wish to serve on.

Question Title

* 6. Please indicate which Caucuses you are interested in

* 5. COMMITTEE SELECTION:
Please indicate the first choice and the second choice of committees you wish to serve on.