Chicago Asthma Consortium Committee Interest Form
Thank you for your interest in Chicago Asthma Consortiums (CAC) Committees!  Please respond to all questions and submit your application upon completion. If you have any questions, please contact the CAC's Association  Manager, Mary Eileen Sullivan at info@chicagoasthma.org or call 888-268-8334.
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Email *
Candidate Information
First and last name
 *
Email *
Phone Number *
Company Name and Mailing Address *
Please check which committee(s) you are interested in learning more about and serving on? *
Required
In what ways does the Chicago Asthma Consortium align with your personal and professional priorities?
Briefly describe your volunteer experience and the extent to which this experience will serve you as a committee member.  If you do not have any volunteer experience, that's okay!  Respond with N/A
 *
Please list anything that you believe could prevent you from fulfilling a committee member role with CAC.
 *
Thank You! Next Steps:
We appreciate you taking the time to submit your information for consideration.
We will review your application and respond to you as soon as possible.
If you have questions, please contact Mary Eileen Sullivan at info@chicagoasthma.org or call 888-268-8334.
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