PHTA Standards Consensus Committee (SCC) Application

PHTA Standards Consensus Committee (SCC) Application

Personal Information
PHTA uses the information in this application to review your qualifications and to assure that PHTA Standards Consensus
Committee (SCC) appointments are made in a way that ensures that the committee will be balanced. Please provide
us with as much information as you feel will assist us in the selection process. Feel free to attach additional pages if
necessary.
*Scope of work: The product lines covered by the SCC will include but not be limited to, residential and public inground
and aboveground swimming pools, inground permanent spas, portable hot tubs (factory built), swim spas, aquatic
recreational facilities and related equipment and components.
Name of Applicant*

PrefixFirst NameMiddle NameLast NameSuffix
E-mail of Applicant*
Phone number of Applicant

Area CodePhone Number
Address of Applicant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Title
Representation

IndividualOrganization
Organization
Indicate the name of the entity you would be representing, if any, and include written authorization from that entity authorizing you to be their representative. Skip this question if you plan to participate as an individual.
Please indicate the interest category that reflects who you represent:

Producer: Manufacturer, builder, or installer of swimming pools, spas, swim spas and hot tubs or components.User-Government: Federal, state, or local regulatory agencies or departments for public safety or others who have responsibility of regulating or monitoring swimming pools, spas, swim spas, or hot tubs.User-Consumer: Any individual/entity that uses swimming pools, spas, swim spas and hot tubs or components. This includes but is not limited to homeowners, owners or operators of, or service professionals engaged with swimming pools, spas, swim spas, or hot tubs, or members of consumer and public safety advocate organizations.General Interest: An entity or individual with expertise in swimming pools, but neither produces nor uses them directly. This category includes but is not limited to consultants, academia, insurance companies, testing laboratories (that test or certify pool and spa components against standards), public interest organizations and “not-for-profits” having an interest in pools, spas/hot tubs.Type
What is your specific relationship to one or more of the product lines in the scope of the committee?
Will you be able to actively participate in the work of the committee including responding to correspondence and ballots electronically and attending internet/web committee meetings?

YesNo

PHTA Standards Consensus Committee (SCC) Application

Applicant Details
Education (List Degrees)
Honors and awards, certifications, patents or inventions, published articles, speaking experience, membership inother professional organizations:
Provide evidence of your general knowledge and competence in the scope (work) of the committee
Upload Resume or Curriculum Vitae (CV) (REQUIRED, click "Save and Continue Later" below if needed)*

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Please upload any documentation or additional details of previous questions

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Additional Comments

PHTA Standards Consensus Committee (SCC) Application

Submit Application
I attest that all of the information on this application is true and accurate.*

Yes
By signing this agreement, I grant PHTA all and full rights in copyright for any proposed language or information that you provide the committee and understand that you have no rights in any publication of PHTA that uses this information in any form. You also agree to abide by the PHTA Antitrust Policy, Volunteer Code of Conduct, and Conflict of Interest Policy, and PHTA's ANSI Accredited Procedures for American National Standards.

In addition, I hereby agree to notify the PHTA, as the Secretariat, of a change in status, including change of employment, organization represented, or funding source. I also agree that PHTA shall have, and I hereby grant, all and full rights in copyright in any material that I author, either individually or with others, as a member of this committee, or that I submit for the proposed use of the committee in an PHTA code or standard or other PHTA document. I further acknowledge that I acquire no rights in any publication of PHTA and that copyright and all rights in all materials produced by PHTA standards or technical committees are owned by PHTA and that PHTA may register copyright in its own name.

I do not now hold and I do not intend to hold any patent, the use of which would be required for compliance with any material that I author – either individually or with others – as a member of this committee, or that I submit for the proposed use of the committee in an PHTA code or standard or other PHTA document.
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