2020 AMTA Representative Application
Thank you for your interest in serving as an AMTA Representative during the 2020 AMTA Tournament season.  Whether you are a new AMTA Representative or returning for another year, please complete the following application to provide updated information to the assignment committee.  

The application submission deadline is November 1, 2019.  If you have any questions or concerns about the application or the process, please contact Michael D'Ippolito, AMTA Representative Subcommittee Chair, at mdippolito3@gmail.com.
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Full Name *
Email Address *
Phone Number *
City of Residence *
State of Residence *
What is your occupation? *
Other than service as an AMTA Representative, please describe your affiliation with AMTA, including: (1) the length of time you have been involved with AMTA activities; and (2) the roles you have held. *
Please list all airports within a 90-minute drive from you. *
Current Institutional Affiliation *
If none, please write "None."
Prior Institutional Affiliation
Please indicate any institution(s) with which you have been affiliated in the last five years, and the month and year when your affiliation ended.
Other Institutional Conflicts
(e.g., a program for which a relative competes)
Have you served as an AMTA Representative before? *
If so, please indicate each tournament at which you served as an AMTA Representative, beginning with the 2019 competitive season (2018-2019).
Location and dates
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