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RESOLVE Volunteer Committee Application 2023
Thank you for your interest in joining the Advocacy Day Volunteer Committee. Prior to filling out the application, please view the
Volunteer Committee Informational Webinar
. Note: If you were on the Committee in 2023, you do not need to fill out an application. If you have any additional questions, contact
advocacyday@resolve.org
.
1.
Please fill out the following:
Name:
Field Is Required
First Name
Field Is Required
Last Name
Employment Information
Employer:
Field Is Required
Employer:
City/Town:
Field Is Required
City/Town:
State / Province:
Field Is Required
State / Province:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AS
FM
GU
MH
MP
PR
PW
VI
AA
AE
AP
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
None
Required
ZIP / Postal Code:
Field Is Required
ZIP / Postal Code:
Email:
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Email:
Phone Number:
Field Is Required
Phone Number:
Yes, I would like to continue or start receiving email communication from RESOLVE.
2.
Field Is Required
Why do you want to join the Volunteer Committee?
(Maximum response 255 chars, approx. 5 rows of text)
3.
Field Is Required
Would you share briefly what your connection or interest is with infertility and the family building community?
(Maximum response 255 chars, approx. 5 rows of text)
4.
Field Is Required
Have you watched the Volunteer Committee Informational Webinar?
Please select response
Yes
No
5.
Field Is Required
Have you previously served on the Committee?
Please select response
Yes
No
6.
Field Is Required
What types of projects are you interested in supporting? Check all that apply:
Recruitment/Retention
Communications
Outreach
Social Media
Event Analytics
Patient Engagement/Social Meet Ups
State Captain Program
Post Advocacy Day Follow up to obtain Co-Sponsors
Other Skills
7.
If you answered other skills in the question above, please explain:
8.
Field Is Required
Have you previously attended a RESOLVE/ASRM Federal Advocacy Day?
Please select response
Yes
No
9.
Field Is Required
Are you able to commit to a volunteer timeline for the committee from October 2022 to April 2023?
Please select response
Yes
No
10.
Field Is Required
Would you be interested in taking on a future leadership role in the committee?
Please select response
Yes
No
11.
Is there anything else you would like us to know?
Spam Control Text:
Please leave this field empty