WIM Volunteer Form

Name and Designations *

Phone and Email *

Position you are interested in * *

Chapter President

Chapter Vice President

Board Director

Region Representative or Alternate Region Representative

Member - Government Relations Committee

Member - Education Committee

Member - Candidate Guidance Committee

Member - Finance Committee

Member - Nominating Committee

What experience or background do you feel especially qualifies you for this position?*

List previous Chapter, Regional and/or National Committees you participated on or activities you feel are pertinent*