ASPPB Volunteer Form

ASPPB is looking for volunteers to help achieve its mission. Volunteering is a great way to network with peers, learn about new initiatives in the profession and contribute to the profession as a whole. Some volunteer activities necessitate travel, while others involve collaboration by email or teleconference. We may not be able to find an opportunity for everyone at this time, but we greatly appreciate knowing of your interest and availability. Please complete this short survey to volunteer. Feel free to contact Leslie Browning at lbrowning@asppb.org if you have any questions.

As written in the ASPPB Policies and Procedures Manual, Volunteers with ASPPB are limited to board members and staff of member licensing boards, ASPPB Individual Members, and members of the ASPPB Board of Directors, with the exception of the examination related committees and item writers.

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* 1. Name:

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* 2. Suffix: (PhD, CPsych, etc.)

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* 3. Company:

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* 4. Address:

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* 5. City/Town:

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* 6. State/Province:

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* 7. Zip/Postal Code:

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* 8. Email Address:

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* 9. Phone Number:

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* 10. Your jurisdiction / board

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* 11. I am a/an:

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* 12. If you are a Member of a Licensing Board, when does your term end?

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* 13. Can you travel to attend meetings outside your jurisdiction?  (ASPPB covers expenses)

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* 14. Have you ever served on an ASPPB committee or task force, or had prior ASPPB service?

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