2014 ITLS Committee Application

View Draft Committee Mandates

All committee applications are due Monday, January 6, 2014. Your application must be submitted online. If you are applying for more than 1 committee, you must fill out the application 1 time for each committee.

Notifications of committee appointments will be made via email in mid-February 2014.

1. Committee Requested:
(If you are applying for multiple committees, you must fill out the online application separately for each committee spot requested.) *This question is required.

2. Full Name: *This question is required.

3. Credentials (MD, RN, EMT-P, etc.): *This question is required.

4. ITLS Chapter or Training Centre: *This question is required.

5. Occupation:

6. Mailing Address: *This question is required.

7. Email Address: *This question is required. This question requires a valid email address.

8. Preferred Phone: *This question is required.

9. Describe any prior involvement with ITLS committee(s): *This question is required.

10. Describe your experience with your ITLS chapter or training centre: *This question is required.

11. What other (non-ITLS) volunteer activities have you been involved with? *This question is required.

12. Can you regularly participant in teleconferences?
(usually 3-4 per year) *This question is required.

13. Please describe any potential conflicts: *This question is required.

14. Why are you interested in serving on this Committee? *This question is required.

15. What do you feel you could contribute to this Committee? *This question is required.

ITLS Conference Registration Policy for Conference Planning Committee Members

The ITLS Conference Registration Policy for Conference Planning Committee members is as follows:

Active Conference Planning Committee members who meet the following criteria will be offered a reduced conference registration fee and have been approved by the committee chair:

Meeting Participation: > 75% of Committee Meetings
Session Monitors: > 1 Conference Session

Local/Host Planning Team:
Local representatives from the host chapter that have significant roles in program development and/or delivery to include equipment and A/V "procurement and management" may be offered a reduced conference registration reimbursement. ITLS Staff will evaluate participation for reimbursement of any conference fees.

Reduced Registration Fees:
The reduced registration fee shall be based on actual per person costs associated with the International Trauma Conference and shall not exceed the Chapter Coordinator reduced conference rate. A dollar amount discount will be recommended by staff and approved by the ITLS Finance Committee during the annual budget process.

Application Attestation *This question is required.

By checking this box, I attest that the above information is true.

I also attest that I have read and agree to the above conference registration fee policy.

Application Attestation *This question is required.

By checking this box, I attest that the above information is true.

2014 ITLS Committee Application

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