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We wish to express our sincere gratitude for your interest to serve. Please take a moment to complete this form.

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* 1. Last name:

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* 2. First name:

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* 3. Credentials:

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* 4. Preferred email address:

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* 5. Preferred phone number:

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* 6. Employer name:

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* 7. Please identify which committee you are interested in sharing your talents with. Rank order your interest in serving, with 1 being high and 5 being low. If you have no interest in a committee, please enter 0. If you have no preference, please enter X under "no preference."

  Ranking of preference
Research and Publications
Marketing and Communications
Philanthropy
Bylaws
Standards, Andragogy, and Guidelines
No preference

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* 8. My interest and experience I bring to this group are: (500 words or less)

T