EmailMeForm
IASA Application for New Volunteers - 2022-23
APPLICANT INSTRUCTIONS
New volunteers may apply for a position on a standing committee at any point during the year. This form is for applicants seeking a position on an IASA Committee for the 2022-23 term.
Volunteers must be current members of IASA at the time of appointment and remain current members throughout their term of service.
APPLICANT DEMOGRAPHIC INFORMATION
Name
*
First
Last
Email
*
Professional Title
*
Company
*
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Non-binary
Race
*
African American
American Indian/Alaska Native
Asian
Caucasian/White
Native Hawaiian/Pacific Islander
Other
Ethnicity
*
Hispanic, Latinx, or Spanish Origin
Not of Hispanic, Latinx, or Spanish Origin
PROFESSIONAL EXPERIENCE & AREAS OF EXPERTISE
Years of Industry Experience
*
Insurance Career Start Year
*
Professional Role
*
C-Suite/ Partner/ Owner
Manager
Staff
Student
Academic (Faculty)
Other
List leadership positions you have held with IASA or in other organizations.
Committee service in other organizations is not required.
PAST IASA INVOLVEMENT
Describe your past participation with IASA.
Chapter Meetings Attendance
IASA Xchange Attendance
IASA Xchange lite Attendance
Webinars Participation
eLearning Center Participation
IASA Sponsor
IASA Exhibitor
Textbook Purchases
IASA Career Center Usage
Select all that apply.
IASA COMMITTEE INTERESTS
Select up to three (3) committees of interest.
Applicant Committee Preferences
Use the drop-down menus below to select the groups you would like to be appointed. Be sure to order your selections by preference (i.e., Committee Selection 1 should be your top choice, etc.).
*
Committee Selection 1
Awards Committee
Diversity, Equity, and Inclusion Committee
Enterprise Risk Management Subcommittee
Executive Education Subcommittee
Insurance Accounting & Finance Subcommittee
Professional Development Subcommittee
Program Planning Committee
Technology Programs Subcommittee
Women in Leadership Subcommittee
Committee Selection 2
Awards Committee
Diversity, Equity, and Inclusion Committee
Enterprise Risk Management Subcommittee
Executive Education Subcommittee
Insurance Accounting & Finance Subcommittee
Professional Development Subcommittee
Program Planning Committee
Technology Programs Subcommittee
Women in Leadership Subcommittee
Committee Selection 3
Awards Committee
Diversity, Equity, and Inclusion Committee
Enterprise Risk Management Subcommittee
Executive Education Subcommittee
Insurance Accounting & Finance Subcommittee
Professional Development Subcommittee
Program Planning Committee
Technology Programs Subcommittee
Women in Leadership Subcommittee
Describe your level of expertise for each committee position.
Advanced
Intermediate
Beginner/Novice
I do not have expertise in this area.
Committee Selection 1
Committee Selection 2
Committee Selection 3
Signature
An applicant signature is required and signifies that the information provided in the application is correct.
*
Clear