Maine Chapter Volunteer Form

Maine Chapter relies on its membership to assist with its duties. If you would like to volunteer to serve on one of the committees, please complete the following information. Once the form has been submitted, it will be sent to the appropriate committee chair who will then contact you regarding your interest.

CONTACT INFORMATION

Name:
Phone:
Email:

ADMINISTRATIVE CONTACT PERSON

If you have a support person who the Chapter may contact when you are in surgery, please provide his/her information:
Name:
Phone:
Email:

COMMITTEES

I'm interested in serving on a committee. Please contact me with details.

COUNCIL

I'm interested in an upcoming position on the Council.

CONTACT US

Contact the Maine Chapter Executive Office at (207) 445-2260 with any questions.
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