AMTA-LA Positions Assigned by Chapter President

AMTA-LA COMMITTEE CHAIR POSITIONS & COMMITTEE VOLUNTEERS

Candidate Application
NOTE: POSITIONS APPOINTED BY CHAPTER PRESIDENT FOR A ONE YEAR TERM.

INSTRUCTIONS

All questions must be answered and your bio and headshot must be attached to your submission.

Thank you for your interest in serving on the AMTA-LA Board!
Name *

First Name Last Name
Louisiana Licensing Information *

Louisiana License Number Date of Louisiana Licensure
Your AMTA Information *

Your AMTA Number Years of AMTA Membership
Name of Massage School Attended *
E-mail *
Phone Number - Cell *

Area Code Phone Number
Phone Number - Work OR Home *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
POSITION APPLYING FOR (Please check only ONE) *

Awards Chair Committee Volunteer Community Outreach Chair Convention Committee Chair Convention Registration Chair Education Chair/Convention Coordinator Event Photographer Government Relations Chair Membership Chair Newsletter Editor Chair Online Elections Coordinator Social Media Chair Website Chair
Experience
AMTA Experience: Please list AMTA chapter or national offices held and/or committee work, including dates. If none, write “N/A.” *
What are your strengths andqualifications for this position? Include experience working withcomputers, websites, events,administration, etc. *
What do you see yourself contributing to this position? *
Community and/or Professional Experience *

Browse Files

Cancel of
Photograph *

Browse Files

Cancel of
Time Commitment
Number of hours you realistically can commit each week to AMTA-LA: *
Do you only want to participate if you can do so from home? *

YES NO
Do you enjoy making phone calls? *

YES NO
Do you enjoy organizing paperwork? *

YES NO
Do you want to volunteer at the AMTA-LA annual convention? *

YES NO
Do you like to organize events? *

YES NO
Input Your Signature *

Clear
Date and Time *
Should be Empty:

AMTA-LA COMMITTEE CHAIR POSITIONS & COMMITTEE VOLUNTEERS

Experience

Time Commitment