Member Interest Form
Please contact me, I'm interested in learning more and getting involved with Disabilities MIG!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I am interested in (select all that apply)
*
Volunteering as an elected member of the Executive Committee (Chair/Chair-elect, Secretary, Treasurer, HOD Representative, Nominating Committee Chair)
An appointed committee chair or member (Communications, Education, IDEA, Membership, Sponsorship,
Content contributor (webinar speaker, newsletter article, networking event)
Other
How much time a week do you have to contribute to this role?
*
.5-1 hours a week
2-3 hours a week
4-5 hours a week
More than 5 hours a week
Please tell us about your skills and experience which qualify you for this role:
*
Please verify that you are human
*
Submit
Should be Empty: