WRC Committee Interest Form

WRC Committee Interest Form

Please fill out the form below to apply to be a peer member of the Wellness and Recovery Committee.

The committee will chose one applicant to help plan the 2024 Pathways to Wellness Conference.

The conference will be held May 10, 2024.

Submit your application by the end of the day on Friday, December 8.
Your Name

First NameMiddle NameLast Name
Your email address
example@example.com
Your phone number
Format: (000) 000-0000.
What is your connection to the peer community in the Northern Virginia area?
How well do you meet the qualifications listed on our flyer?
Why do you want to serve on this year’s Wellness and Recovery Committee?
You may share your resume. It is not required.

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