Committee Interest Form

Fill out the form below we would love to have you on a committee! Please let us know what committee (or committees) you are interested in and a committee member will contact you to go over the committee in detail.

Just want some info?:
Feel free to reach out to any of the co-chairs or board members or email: committeeinvolvement@pmpi.org

Website URL (required)

*Name:

Title:

Organization:

Address:

City:

State:

Zip:

*Phone:

Fax:

*Email:

I am interested in the following committee(s)
(Please check all of interest.)

	Ad Hoc Committee
	Community Outreach Committee
	Educational Development Committee
	Member Care Committee
	Marketing & PR Committee
	Publications Committee
	Student Relations Committee
	Strategic Events Committee
	Strategic Alliances & Site Selection (SASS) Committee
	Member Recognition Committee
	Mid-Atlantic Conference and Expo (MACE) Committee
	Leadership Development Committee
	Career Development Committee

The best time for me to attend a committee meeting is:

This is my first Committee experience with PMPI:

Although I cannot serve as a full-time committee member, I can offer special talents when needed:
(Please check all of interest.)

Comments:

* Indicates Required Fields