Volunteerism Survey

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* 1. First Name

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* 2. Last Name

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* 3. Component Society (select one)

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* 4. Preferred email address

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* 5. Cell phone

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* 6. Areas of interest to you (select all that apply)

Social Media / Web Content

Membership & Communications

Bulletin (quarterly publication)

Component Relations (support for local societies)

Advocacy (legislative efforts)

Governance (internal workings, bylaws, evaluation)

Delegation

Continuing Education / Virtual Learning

Event Planning

Policy and Procedures

Investments/Finance

Current Critical Issues (ortho staffing issues)

Area of greatest need

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* 7. What levels of governance are you interested in?

Component (state or province)

Constituent (PCSO)

National (AAO / CAO - Canada)

Any of the above

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* 8. How much time are you able to commit to a volunteer position (select all that apply)?

Short-term commitment (e.g., for an event like PCSO Annual Session or task force)

Mid-term commitment (e.g. committee member)

Long-term commitment (e.g. board position or delegation work)

Would like to learn more about available opportunities

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* 9. Are you willing to travel?

No (remote positions - email, conference calls)

Yes, if in conjunction with PCSO events (Annual Session, Spring Meeting, AAO Annual Session)

Yes

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* 10. Do you have any contacts that would be beneficial to the PCSO (select all that apply)?

Political

Industry Partners

Academic

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* 11. If yes, please list any such relationships.

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* 12. What is your gender? (to assist in balance for volunteer distribution only)

Female

Male

Non binary

Prefer not to answer

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* 13. In what year were you born - 4-digit birth year? (to assist in balance for volunteer distribution only)

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* 14. How many years have you been in practice? (to assist in balance for volunteer distribution only)

Resident

< 5

6 to 10

11 to 20

20 to 30

30 to 40

40 to 50

> 50

Academic

Retired