2024-2025 Advisory Committee Re-Application

In addition to new applicants eligibility requirements, please note only applicants serving in the preceeding year are eligible to use this re-application form (current Board Members not eligible).

Applications are due Wednesday, June 19, 2024 at 5:00p.m. CST.

Name:*

First Name

E-mail:*

IIDA Member ID:*

IIDA Member Type:*

(Professional IIDA (note if an Educator) or Professional Fellow FIIDA)

Membership in Good Standing? (Paid)*

YesNoNot Sure

Current City Center:*

(Eastern Iowa City Center, Des Moines City Center, Omaha City Center, South Dakota City Center)

Personal Phone:

Area CodePhone Number

Only answer the following if your employment has changed in the last year:

Employer:

Position Title / Role:

Please check any that apply to your current job position:

Sole OwnerPartnerShareholder

Work Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work Phone:

Area CodePhone Number

1. List any additional related professional experiences including employment, state boards, professional association involvement, research, publications, etc. within the last year.

0/250

2. List any professional examinations you have successfully completed (NCIDQ, ARE, LEED, CHID, etc.). Include year completed, exam, and examination appellation if applicable (i.e. LEED AP ID+C) in the last year.

0/250

3. What improvements would you like to see for the Chapter's Advisory Committee?

0/250

7. If you have a new headshot, please upload it here. If selected, all headshots submitted shall be subject to use by the Chapter for the announcement of the Advisory Committee and anything to follow in relation to the Committee and their work.

Browse Files

100 MB limit

By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

E-Signature:*

Thank you for your interest in this opportunity and your support of this Chapter!

2024 - 2025 Advisory Committee Re-Application