Volunteer Interest Form

Name

Organization

Professional Title

Email

Phone

Committees You Are Interested In

Audit Committee

Communications/Marketing (Social Media and Website) Committee

Corporate Relations Committee

Legislative/Advocacy Committee

Finance Committee

Member Relations Committee

Nominating Committee

Program/Continuing Education Committee

Comments

Volunteer Intake

TxHIMA Membership Status

Member

Not a Member

OtherOther

Review Status

Pending Review

Approved

Declined

On Hold

Reviewed By:

Review Date

Reason for Decline or Hold

Communication Sent

Yes

No

Communication Method

Email

Phone

OtherOther

Communication Notes

Follow-Up Required

Yes

No

Follow-Up Date

Committee Commitment Start Date

Committee Commitment End Date

Board/Chair Introduction Sent

Yes

No

Conflict of Interest Document on File

Yes

No

Conflict of Interest Last Signed Date

Orientation/Onboarding Completed

Yes

No

Orientation/Onboarding Completed Date

Volunteer Agreement / Code of Conduct Signed

Yes

No

Volunteer Agreement / Code of Conduct Date Signed

Internal Note

Volunteer Intake

Contact

Quick Links