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* 1. Name

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* 2. Company

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* 3. Title

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* 4. Work Address

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* 5. Phone

Instructions: Please check all that apply, or provide brief answers to the following questions. This application is intended to provide the selection committee with sufficient information to make informed appointments. No applicant will be granted or denied a seat on the committee based solely upon responses to these questions.

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* 7. The company I work for builds climbing walls.

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* 8. The company I work for manufacturers impact attenuating surfaces.

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* 9. The company I work for manufactures equipment used on climbing walls.

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* 10. The company I work for operates a climbing facility.

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* 11. I do not work professionally in the climbing industry, and would represent the public’s interests on the committee.

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* 12. Do you have previous experience in credentialing, or standards development?

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* 13. Describe the support your organization is willing to provide to you for your participation on the CWA Competition Training Committee (time, travel allowance, etc.).

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* 14. How many days of volunteer time could you commit to per year? (At a minimum, committee members are expected to participate in periodic teleconference meetings, participate in voting related to standards activities, and spend an average of two hours per week on CWA business).

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* 15. Do you hold any licenses, certifications, other credentials that might be relevant to the work of the committee?

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* 16. Briefly describe any other relevant experience or areas of expertise you may have that might be relevant (use separate sheet(s) if necessary).

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* 17. Is there anything else you would like to share with the selection committee?

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