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CCI Volunteer Interest Form

1.Upload the most recent copy of your CV (required)(Required.)
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2.Please provide your contact information(Required.)
3.CCI credentials (select all current and active CCI credentials that you hold)(Required.)
4.Other designations (select all current and active designations that you hold)(Required.)
5.What year did you earn your first cardiovascular credential?
6.Work Experience Specialty (select all that apply)(Required.)
7.Do you currently participate in the development, delivery, or presentation of any resources intended to help individuals prepare for or pass a CCI examination?(Required.)
8.Work setting (select the response that best describes your primary work setting)
9.What motivates you to volunteer with our organization, and what do you hope to contribute or gain through this experience?
Optional Supplemental Survey: Diversity, Equity & Inclusion
At CCI, we strive to create an environment where everyone feels respected, valued, and included. Participation in this section of the survey is completely voluntary. Please feel free to answer as many or as few questions as you are comfortable with, including choosing not to respond at all.
10.Race: How do you identify?
11.Gender Identity: How do you identify?
12.Sexual Orientation: How do you identify?
13.What is your age range?
14.Accessibility Experience: Do you identify as someone who may experience barriers to accessibility, health, or functioning?
15.Which languages are you fluent in or have a high level of proficiency? (select all that apply)