Volunteer Interest Form Gender MF Present working status (select one) Full TimePart TimeInactiveWorking in another field Setting of professional activity (select one) Hospital or Clinic (ie private practice)*FarmCollege or UniversityBusiness or IndustryPublic HealthAdministration/Regulatory *Type of private practice (select one) Small Animal (canine or feline exclusive?)Mixed AnimalLarge AnimalBovine Exclusive (diary or beef exclusive?)EquineSwineLab AnimalExotic/Zoo Animal Have you previously served as an ISVMA volunteer? YesNo Have you ever attended the ISVMA convention? YesNo Volunteer Interests (please check as many as apply) Committees/Leadership Legislative CommitteeMembership CommitteeNominations & Awards CommitteeEducation Planning CommitteeMuseum & History CommitteeFinance/Audit CommitteeExhibitor Relations CommitteeSponsorship CommitteePublic Relations CommitteeVeterinary Profession Task Force CommitteeGovernance Task Force CommitteeBoard of DirectorsOfficer (President, Vice-President, President-Elect, Past President, Treasurer)Illinois Veterinary Medical Foundation Convention Moderator Student Relations Mentor Legislative Grassroots advocateLobby Day Participant
