Ignition Interlock Working Group Application Form
AAMVA is establishing a working group to revise the 2015 ignition interlock program best practices and to develop best practices for ignition interlock cross-jurisdiction reciprocity. This Working Group will operate under the auspices of the AAMVA Law Enforcement Standing Committee.
After reviewing the required qualifications below, please complete this form if you are qualified and interested in serving on this Working Group.
Contact Information
Name: / Click here to enter text.Title or Rank: / Click here to enter text.
Agency or Organization: / Click here to enter text.
Name of Organizational Unit within Agency: / Click here to enter text.
Street Address: / Click here to enter text.
City, State & Postal Code: / Click here to enter text.
Work Phone: Click here to enter text. / Email Address: Click here to enter text.
I am a (you must check one):
Click here to enter text. DMV employee with experience in ignition interlock program management/administration and/or policy setting.
Click here to enter text.DMV legal representative.
Click here to enter text.State Police/Highway Patrol Officer with extensive DUI enforcement and/or experience with ignition interlock compliance enforcement.
Click here to enter text.Executive management employee of an Ignition Interlock manufacturer that is not a member of the Coalition of Ignition Interlock Manufactures.
Applicant Qualifications:
In addition to meeting one of the above job descriptions, please attach a short biography. Applicants chosen to be a member of the Working Group must be willing to travel. Working Group members may also be given “homework” assignments to complete. It is expected that members who volunteer for this working group will complete that work in the amount of time agreed upon. In addition, conference calls will be scheduled on an as needed basis. Members are required to make a good faith effort to attend and actively participate in all Working Group meeting(s) and conference calls.
If you meet the above qualifications and are interested in applying for this Working Group, please return the completed Working Group Application Form no later than October 6, 2017
to Dianne Graham ()
Agreement and Signature
By submitting this application, I affirm that I meet the qualifications and am willing to serve on the Working Group if selected. As supervisor, I authorize this applicant to serve if selected.Name (printed): / Click here to enter text.
Signature: / Click here to enter text. / Date: Click here to enter text.
Supervisor Name (printed): / Click here to enter text.
Supervisor Signature: / Click here to enter text. / Date: Click here to enter text.
Our Policy
It is the policy that all applicants must obtain the permission of their supervisor and/or chief administrator prior to submitting the application. Incomplete applications will not be accepted. Thank you!09/28/15
Short Biography
Click here to enter text.