Volunteer Interest Form

First Name *		Last Name *
Are You a CCSHRM Member? *	Yes No
Email Address *
Cell Phone with Area Code *
Professional Title *
Organization *
Count me in! I'm interested in: *	Learning about future Board opportunities Serving as a committee member Presenting/Speaking at an upcoming program Serving as a Mentor
What experiences and skills make you a good fit for the role your volunteering for?	5000 of 5000 characters remaining