APHA Volunteer Form

APHA Volunteer Form

for Awards, Chapter Leadership, Diversity, Mark Samuels Lasner Fellowship, Membership, Nominating, Programs, and Publications (all one-year terms)
Name*

First NameLast Name
Affiliation
Email*
example@example.com
City and State/Province*
Please enter your geographic location, including state/province.
Which Committee(s) Are You Interested In?*

Awards Committee (Individual and Institutional Honorees)Chapter Leadership (Chair, Vice Chair, Recording Secretary, Treasurer)Development (sustainable funding for national and chapter initiatives)DiversityMark Samuels Lasner FellowshipMembership (Marketing, Outreach, Mentoring)NominatingPrograms (Conference, Lieberman and other Lectures)Publications (Editorial, ENewsletter, Website)
What day(s) of the week you are available for virtual meetings?*

MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays
What time(s) of day are best for you to attend virtual meetings?*

Mornings (10:00 - 12:00)Afternoons (12:00 - 4:00)Evenings (6:00 - 7:30)
How often would you be able to attend?*

Bi-weeklyMonthlyQuarterly
Please note:
- Committee chairs schedule meetings at a mutually convenient time for all committee members, across time zones
- Conference program planning typically occurs between May and October; planning for the Lieberman Lecture typically occurs in Autumn (September - November) of each year
- APHA's Awards Committee work typically is conducted between May and October
- The Mark Samuels Lasner Fellowship Committee meets in January
- Nominating Committee meets in autumn and early winter (September - January)
Are you a part of any other committee with any other organization or group?*

Yes (please elaborate, below)NoI am applying for other committees, and waiting to hear back (please elaborate, below)
Please indicate all other service in which you are currently engaged (e.g., local/state/global committees; American Library Association (ALA) service; service in other organizations (BSA, SHARP, &c). Where applicable, please indicate term(s) in office(s).*
(Open text)
Are you currently on any APHA committees? (In efforts to promote emerging voices, participation is limited to no more than two (2) APHA committees at one time.)*

Yes (please explain in the section immediately above)No
Please indicate any and all ways in which you self-identify:*
Examples: race, ethnicity, gender, sexual orientation, disability, low-income, regional identity
Are you interested in serving as a chair or vice chair? (Chairs receive training before taking office.)*

YesNo
What influenced you to want to be part of the committee(s) for which you are applying?*
(Open text)
Anything else you think we should know?
Should be Empty: