Personal Data:
Name ________________________
Address ____________________ City/State _____________ Zip ___________________
Telephone (Home) _____________________ Best time to contact _____________________
(Work) _____________________ Best time to contact _____________________
(Fax) _____________________ Email address _____________________
Position Desired:
___President _____ 1st VP ___2nd VP ___3rd VP ___Secretary ___Treasurer
(Please answer the questions on a separate piece of paper and attach to the form)
1 AMTA or other professionally affiliated office held including dates
2 Relevant professional or community experience
3 Other qualifications
4 Reasons and objectives for seeking this office
5 How many hours per week are you able to commit to perform duties of this position
Submit Officer/Delegate Brief along with signed Chapter Code of Conduct to:
Sara Toogood
PO Box 184
Holly Springs, NC 27540
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
by August 2, 2011
To find out more about open positions and responsibilities, you can find on the website and/or newsletter.
Contact any board member or check online at www.amtanc.org in the volunteer section.
Contact any board member or check online at www.amtanc.org in the volunteer section.
