Please complete this form and attach a recent head and shoulders picture of yourself. Committee selections are for National Directors only. Contact Form * indicates required field Name:* Email:* Please check if you are a CM. Please check if you are a PMP. Chapter Name or Individual Member:* Chapter Number if Chapter Member: Company Name: Company Address: Company Phone: Preferred Mailing Address (company or home):* Birthday: Spouse/Partner: Home Address:* Home Phone: Cell Phone: Home Email: First Committee Preference (select 1): Association Services/Development Recognition Second Committee Preference (select 1): Professional Development Community & Communications Attach Picture: Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.Maximum file size: 1mb. CAPTCHA Code:* Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Name * Email * Website Notify me of new posts by email. What's on your mind?