Exit this survey WWCMA Volunteer & Director Application Question Title * 1. Please provide your contact information. Name: Job Title: Employer: Address: City: State: Zip: Home Phone: Work Phone: Cell Phone: E-mail: Question Title * 2. Please choose the category that best defines your current organization: Private/Public Employer (Human Resources or Benefits/Wellness Program Management) Health Plan / Insurance Provider Broker / Consultant Wellness / Specialty Vendor Nonprofit Organization Governmental Agency Unaffiliated Other (please specify) Question Title * 3. Are you available to answer WWCMA phone calls or e-mail during: Yes No Early Morning / Before Business Hours Early Morning / Before Business Hours Yes Early Morning / Before Business Hours No During Business Hours During Business Hours Yes During Business Hours No Lunchtime Lunchtime Yes Lunchtime No Evenings Evenings Yes Evenings No Weekends Weekends Yes Weekends No Question Title * 4. Are you available to attend WWCMA meetings/events during: Yes No Early Morning / Before Business Hours Early Morning / Before Business Hours Yes Early Morning / Before Business Hours No During Business Hours During Business Hours Yes During Business Hours No Lunchtime Lunchtime Yes Lunchtime No Evenings Evenings Yes Evenings No Weekends Weekends Yes Weekends No Next