Missouri Middle School Association

Application to serve on a committee/area of interest

 

 

 

Thank you for your willingness to serve the Missouri Middle School Association by serving on a committee or other area of interest. The size of each committee has been established by the Board of Trustees and committee members serve staggered terms of two years. All appointments to committees and other areas are made by the President-Elect or President of MMSA. This application will remain on file for three yeas from date of application. Committee members and other areas of interest members must be members of MMSA.

 

Name__________________________________________________________________

 

Current Position__________________________________________________________

 

Name Of Institution____________________________________________________

 

Work Address_______________________________________Work Phone________________

 

City__________________________________ State_______________Zip_____________

 

E-Mail Address____________________________________________________

 

 

I am interested in serving on the following MMSA Committee/Other area of interest. Select top three choices by indicating 1, 2, and 3.

 

Committees

____Legislative

____Nominations

____Elections

____Conference

 

Other Areas

 

____Volunteer at Annual Conference

____Correspondence

 

 

 

Demographic Area Represented:

____Large urban    ____Small urban    ______Suburban     ______Rural

 

 

 

I believe that serving on these committees/areas would permit me to provide the following service to MMSA:

 

 

 

 

Specific skills that I would bring to these committee/areas are:

 

 

 

 

 

Other activities I have been involved in that relate to these committees/areas/concerns:

 

 

 

 

 

I am a member of the following professional organizations:

 

 

 

 

OPTIONAL-please complete the information below to assist MMSA in maintaing ethnic and gender balance on all committees/areas.

 

______Native American    ____Asian    ____African American

 

____Hispanic    ____Caucasian     _____Other (specify)

 

 

Gender:     ____Male    ____Female

 

 

Mail to:

 

MMSA

224 N Highway 67, #127

Florissant, MO 63031