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WANTED: NSTA Committee Members

STEP 1: Personal Information

First Name:  
Last Name:  
Member ID:


STEP 2: Select Committees

Please check the appropriate box and complete the related experience question in Step 3, for each committee choice. Choices are limited to 3 committees.

Standing Committees
(3 Openings Each)

Advisory Boards
(1-3 Openings Each)

Panels
(3-5 Openings Each)


STEP 3: Justify Committee Selections

What experience do you have that directly relates to the work of these committees?


STEP 4: Address Preference

Preferred Contact Address:
Publish Home Address:

STEP 5: Work Address

School/Business:
Title:
(e.g. 4th Grade Teacher)
Address 1:
Address 2:
City:
State/Province:
Zip:
Phone: - - ext.
Cell Phone: - -
Fax: - -
Email:  

STEP 6: Home Address

Address 1:
Address 2:
City:
State/Province:
Zip:
Phone: - -
Cell Phone: - -
Fax: - -
Email:

STEP 7: Additional Questions

I plan to attend this year's National Conference in St Louis, MO


I am currently serving on an NSTA committee?
If yes: which committee:
  term expires:


I have served on an NSTA committee in the past 6 years?
If yes: which committee:
  term expired:


Educational Experience
Include present position, dates, and previous positions

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Education

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Professional Background

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