Applicant Name:
Employer Name:
Are you a NENA Member? Yes ☐ No ☐
Currently ENP Certified? Yes ☐ No ☐
Present Committee Duties:
Contact Telephone Number:
Email Address:
NENA Committee/Working Group(s) or topicsthat you are interested in leading:
Others from your agency /company/ currently participating in Committee or associated Working Groups:
9-1-1 Knowledge/Experience/Professional Goals (briefly):
Other Helpful Information (Project Management & Facilitation skills, etc.):
If appointed, do you agree to accept Committee leadership requirements as identified below?
Verification of my agency/company’s support for my role in this position can be obtained by contacting (name, title, TN & email):
Submit completed form to NENA Development Committee Co-Chair
Refer to the NENA Web Site for current Co-Chair information.
Committee, Working Group Leader Commitment Statement
I commit to actively leading the designated Development Committeeor Working Group. I agree to maintain my paid membership status. I agree to supply an active Internet email address for Committee information distribution. Leading a Development Committee is a time and effort commitment. I will assist the Committee Resource Manager in maintaining an Issues List with due dates and completion dates, and I will adhere to the requirements of the NENA Organizational Structure(NENA-ADM-001) and the NENA Document Development andApproval Process(NENA-ADM-002) Documents.
The Development Committees and Working Groups hold meetings via teleconferenceat least one time each month throughout the year (with some groups meeting weekly or bi-weekly). I agree to the requirements that I will notify the Development Steering Council/Committee Chair (as applicable) if I am unable to attend a scheduled meeting or risk removal from Committee leadership after three (3) unexcused absences.
The Development Group may hold at least three (3) face to face meetings each year. They are in association with the Standards &Best Practice Conference, the Annual Conference and the Fall Development Group Meeting. Attendance at these Conferences is essential.
NENA Volunteers acknowledge that leading and participating on NENA committees, sub-committees and working groups will likely require personal and/or organization financial resources. Each member is encouraged to work with their employer and others to explore potential funding mechanisms. Further, NENA members are encouraged to consult with their tax professional about the potential tax implications of their individual travel expenses.
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