Oncology Nutrition DPG Election and Volunteer Interest Form

Thank you for your interest in getting more involved with the ON DPG.

Please indicate below which volunteer position you are interested in. Open positions are filled throughout the year. Elected leadership position nominations (Chair-elect, treasurer, etc.) will be accepted through Friday, October 21, 2022.

Name *

First Name Last Name

Credentials *

Email *

example@example.com

Work Phone Number

Please enter a valid phone number.

Home or Cell Phone Number *

Please enter a valid phone number.

Current Employment Position

Which volunteer roles are you interested in? (select all that apply) *

Elected Leadership Position (Chair-Elect, Nominating Committee Chair, Treasurer, HOD Representative) Volunteer Coordinator E-Bast Coordinator Website Research Update Coordinator Student Membership Coordinator

Please select the position for which you would like to be nominated.

ON DPG Chair-Elect (3-year term) ON DPG Nominating Committee Chair-Elect (2-year term) ON DPG Treasurer(2-year term) ON DPG House of Delegates Representative (3-year term)

Do You Currently Hold or Are You Running for Another Elected Position? *

Yes No

Volunteers are required to attend, at minimum, their committee meeting and the ON DPG Executive Committee meeting each month, for approximately 2 hours. Can you commit to participating regularly to these meetings or submitting written reports in your absence? *

Yes No

Personal Statement: Tell us why you are interested in running for this position in 100 words or less *

0/100

Please List Technology or Other Skills Related to the Position:

Please List Academy-ON DPG and Oncology Nutrition Related Organizational Activities (begin with most recent):

Please List Leadership Positions Held (begin with most recent):

Please Upload Current CV/Resume *

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Please Upload Professional Headshot *

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