Council and Subcommittee Application Form

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Contact Information

Name

First

Middle

Last

Suffix

Member ID

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Cell Phone

Work Phone

Qualifications of Candidate

Please list any previous experience including committee/officer experience at local, state, and national level.

List any degrees or credentials that you currently hold.

Work Experience (check all that apply):

Other

Total Years Experience:

If you have specific councils or subcommittees of interest, please indicate and describe specific experiences or activities that you believe enhance your qualifications to serve on a national council or subcommittee.

Council Volunteer Agreement

*YES, I will accept the President’s volunteer appointment to a council. I understand that because many members volunteer each year and are not accommodated due to the limited number of assignments available, it is imperative that those who are selected commit their time, talent, and cooperation to the project. Therefore, in accepting my appointment, I promise to be responsible to ADAA and my colleagues as follows:

I shall be thoroughly knowledgeable of the ADAA Bylaws, Manual of Procedures, Policies, and Strategic Plan, specifically as they pertain to my Council and its assignment(s).
I shall have computer and e-mail access in order to read, review, and respond to all e-mail correspondence on a regular basis.
I shall attend and participate in all meetings and conference calls, and e-mails realizing that failure to do so could result in my being replaced on the Council.
I shall communicate knowledge actively and regularly, bringing pertinent information and business to the attention of the Council.
I shall accept responsibility for decisions and support the decisions of the Council, regardless of personal opinions.
I shall complete assignments that I volunteer to do for my Council within the established deadlines.
I shall be subject to evaluation at year-end to determine future Council participation.

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By entering your name below, you accept all of the above.