MSCA Committee Interest Form

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Please note completing this form doesn't guarantee you'll be added to a particular committee. For more information, or questions, please contact Jill Hancock at jill@c2cpro.solutions.

Name *

Title
*

Email Address
*

School/District/Institution
*

Phone
*

Gender
*

Female

Male

Nonbinary/Third Gender

Prefer Not to Say

Race
*

American Indian or Alaska Native

Asian

Black or African American

Latinx

Native Hawaiian or Other Pacific Islander

Two or More Races

White

Prefer Not to Say

I'm interested in being considered for the following committee(s).
*

Equity & Inclusion Committee

Ethics Committee

Member Linkages Committee

Professional Development Committee

Professional Recognition Committee

Program Committee (sign up will be for 2025 planning)

Publications & Papers Committee

Required

Questions/Comments

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