RESNA Education Committee Volunteer Interest Form

RESNA Volunteer Interest Form

Please complete this form by January 15, 2014 for consideration.

Question Title

* 1. Personal Information

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number:

Question Title

* 2. Participation:

Typically, committee sub-committees meet bi-monthly via conference call with assignments for members in between.

I have noted my area of preference below: (select up to three; use 1, 2, and 3 to prioritize)

	First	Second	Third	Not interested
CEU review and Conference IACET compliance sub-committee/ad-hoc	CEU review and Conference IACET compliance sub-committee/ad-hoc First	CEU review and Conference IACET compliance sub-committee/ad-hoc Second	CEU review and Conference IACET compliance sub-committee/ad-hoc Third	CEU review and Conference IACET compliance sub-committee/ad-hoc Not interested
Needs analysis survey and webinar sub-committee/ad-hoc	Needs analysis survey and webinar sub-committee/ad-hoc First	Needs analysis survey and webinar sub-committee/ad-hoc Second	Needs analysis survey and webinar sub-committee/ad-hoc Third	Needs analysis survey and webinar sub-committee/ad-hoc Not interested
Fundamentals Course Development sub-committee/ad-hoc	Fundamentals Course Development sub-committee/ad-hoc First	Fundamentals Course Development sub-committee/ad-hoc Second	Fundamentals Course Development sub-committee/ad-hoc Third	Fundamentals Course Development sub-committee/ad-hoc Not interested

Question Title

* 3. Commitment:
I understand that RESNA does not fund any expenses for committee activities, other than conference calls arranged by the committee chair and required travel for committee in-person meetings. I also understand that I must be a current RESNA member to participate on a committee.

Yes

Name: