Red Iguana Project Team Application Question Title * 1. Please provide the following contact information: Name: * Company: Email Address: * Phone Number: * Question Title * 2. Please list any certifications or relevant credentials that you currently hold. Question Title * 3. How many years have you been engaged in exposure assessment and/or risk assessment related work or studies? Question Title * 4. Please select the ONE option that most closely aligns with your current work, position or stakeholder group you are seeking to represent. Academic AIHA Volunteer Group/Technical Committee Industry/manufacturer, large multinational Industry/manufacturer, small – medium enterprise Government, research (e.g., NIOSH) Government, operations (e.g., military, national laboratory) Government, regulatory/enforcement agency Labor (e.g., union member, bargaining unit representative, AFL/CIO staff) Question Title * 5. Please list prior and current service for AIHA (e.g., Volunteer Groups, Board). Question Title * 6. Select the ONE option that most closely aligns with your current level of experience. Level 1: Your work is this subject area is monitored by a supervisor or senior employee to ensure compliance with proper procedures. Level 2: You performed work in this subject area independently and normally without review by a supervisor or senior employee. Level 3: You supervise performance of work by others in this subject area or are normally the person who is consulted by others to assist them in this subject area because of your expertise. Level 4: You are responsible for hiring qualified individuals to perform this work, but do not directly supervise or provide hands-on assistance with the work. Level 5: You are responsible for training qualified individuals to perform this work, but do not directly supervise or provide hands-on assistance with the work. Question Title * 7. Please include a brief statement of why your skills and experience would make you a valuable contributor to the Red Iguana Project. Question Title * 8. Select ALL participation options for which you would like to be considered. Core Team. requires participation, in-person or virtually, at the 14 – 16 NOV 2014 (FRI – SUN) development meeting. NOTE: Expenses for travel to this meeting will be covered by AIHA. Review Team: Able/willing to provide input for consideration by Core Team (virtual, before and after NOV 2014 Core Team Meeting) Stakeholder: Able/willing to provide comment on draft BoK document(s) (virtual, after NOV 2014 Core Team Meeting) Question Title * 9. COMMITMENT TO FULFILL THE ROLE AND RESPONSIBILITIES OF A CORE TEAM MEMBER. YES, I have read the proposed role and responsibilities for the Red Iguana Core Team and am able to fulfill this commitment. I understand this commitment requires (1) review of provided reference materials and summary documents prior any scheduled meetings, (2) participation at a 2 ½ day working meeting to be held 14 – 16 NOV 2014, (3) participation in a post-meeting survey to clarify inputs, (4) participation in a virtual roundtable for additional discussion NO, I do not want to be considered for participation in the Core Team. Done