Committee/SIG Interest Form

If you are interested in contributing your skills and you are an active member, please fill out the information below for consideration of a committee appointment. STN's leadership looks forward to your participation.

Contact Information
Tell us all about you.

First Name:
Last Name:
Prof. Credentials:
Title:
Institution:

Address 1:
Address 2:
City:
State:
Zip:
Country:

E-Mail Address:
Phone:
(Include best number to contact)

Experience and Skillset
List below any skills or experience that you could offer to STN as a volunteer (i.e. experience working with state legislators, leadership experience, etc.)


Committee Interest
Indicate the Committee or SIG Steering Committee on which you would like to most serve. You may choose up to three committees.

First Choice:
Second Choice:
Third Choice: