ISCEBS Committee Volunteer Interest

ISCEBS Committee Volunteer Interest

Member First Name*

Member Last Name*

Job Title

Company

City

State/Province

CEBS Graduate*

Select

CEBS Compliant*

Select

Preferred Phone*

Email*

Area of Expertise

Select

Committee(s) of Interest

Select

Society Contributions

Please indicate local chapter affiliation and describe your contributions to the local community.

Symposium Attendance

Select

Symposium Participation

List any speaker, moderator or facilitator roles you held.

Other Contributions

Describe your contributions to the International Foundation, the Society or the CEBS Program.

Industry Organizations

List names of organizations and offices/positions of responsibility held.

Additional Information*

Please explain why you would like to serve on an ISCEBS committee and what contributions and perspectives you could share. (500 word maximum)

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