SIS Volunteer Interest Form
I am interested in getting involved with or learning more about the following SIS committee(s):
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Organizational Development Committee (High Need – Openings Available)
Education Committee (High Need – Openings Available)
Program & Awards Committee (High Need – Openings Available)
Membership Engagement & Outreach Committee (Openings Available)
Fellowship Committee (Openings Available)
Research & Guidelines Committee (Almost full)
Governance Committee (Almost full)
Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization
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Are you an SIS member in good standing?
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Please Select
Yes, my membership is active and my dues are paid up to date.
No, my dues have lapsed/expired. (Please renew your membership before submitting this form).
No, I am not an SIS member yet but would like to join.
What is your current SIS Membership Type?
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Please Select
Regular Member – Standard active membership for physicians and scientists.
Non-Physician Member – For allied health, nurses, pharmacists, epidemiologists, techs, etc.
Senior Member – For members 65+ or those retired from practice.
International Member – For individuals residing outside the United States.
Candidate Member (Student)
Candidate Member (Resident)
Candidate Member (Fellow)
Candidate Member (Scientists in training)
I am not a member yet / Not sure
What is your current career stage?
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Please Select
Medical Student
Resident
Fellow
Early Career (First 1–5 years in the field)
Mid-Career (6–15 years of experience)
Senior / Late Career (16+ years of experience)
Retired / Emeritus
Other
Would you be willing to serve on a committee of "greatest need" if your preferred selections are unavailable?
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Please Select
Yes, put me where I can help most!
No, please keep me limited to my selections.
Submit
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