SWMOA Member Committee “Willingness to Serve” Form MemberSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Suffix*Job Title*Company*Mailing Address*City*State/Province*ZIP/Postal Code*Country*Telephone*Cell phoneEmail* Website Communication and Data Sharing PreferenceSWMOA has been diligent in Data Security and being compliant with US and other Nations regulations in sharing your contact information as well as receiving email communications from SWMOA on upcoming events and other resources.I would like to receive email messages from SWMOA about Events, Newsletter or Activities*YesNoAuthorization for receiving publication email notification from SWMOA. (applies to all email addresses on this form)I would like to network with SWMOA Members, Operators, Attendees, Speakers, Moderators, Exhibitors, Sponsors or Board, please share my contact information (cell phone # will not be shared)*YesNo I hereby affirm that:• I am a SWMOA Member and interested in serving on a Committee; • If approved by the SWMOA Board, I am willing to serve at least one year; • SWMOA Committee’s that I am interested in serving on are marked below; • If approved, I am willing and able to participate in monthly Committee meetings either in person or via conference call, and follow through on action items as assigned; • I understand that if approved, I should expect to volunteer at least 2 hours per month to fulfill my Committee duties (committee participation, write Committee articles for quarterly newsletter and other assigned action items); • I understand that I must maintain active SWMOA member status in order to serve; • I will complete the Biography below for the Board’s consideration; • I understand that the submission of my name to the Board for consideration does not guarantee a place on a Committee; • If approved, I will provide a photo as a jpg image for the SWMOA website within five business days of notification of selection.* I agree to all of the above terms and conditions Awards Legislative / Regulatory Membership Operator Certification Program / Technology Transfer Publications / Newsletter Public Relations / Social Media Photo and Biography Photo for SWMOA websiteAccepted file types: jpg, png, pdf. Biography*Please provide one paragraph – 150 words or less. Comments and CaptchaQuestions/CommentsCaptchaPlease enter the letters displayed above to complete the form and then click Submit.