International Association of Plumbing and Mechanical Officials

APPLICATION FOR COMMITTEE APPOINTMENT

 

Name
IAPMO Membership Number

 

 

IAPMO District

 

 

Northern
Central
Southern
Outside U.S.

District Map
Home Address
    City
    State
    Zip
    Country
Home Telephone
Home E-mail
Jurisdiction or Company
Work Address
    City
    State
    Zip
    Country
Work Telephone
Work E-mail
If you are a government member, will your jurisdiction allow your participation on an IAPMO committee? Yes No
Year of last IAPMO conference attended
Number of IAPMO conferences attended

Committee Interest
Please indicate the committee(s) on which you would like to serve.

    Code Answers and Analysis (UMC)
    Code Answers and Analysis (UPC)
    Code Workshop (UMC)
    Code Workshop (UPC)
    Publication Development (formerly known as Education)
    Education and Training (formerly known as Career Services)
    Product Certification
    Standards Review
    Evaluation Services
    Green Technical
    Committee for the Awareness and Understanding of a Sustainable Environment (C.A.U.S.E.)

For first time applicants, a resumé can accompany this application, and is preferred.
Resumes must be less than 10mb and in .DOC, .TXT, .PDF, or .RTF format.
 

 

Education - High School and Beyond

Name of School Location of School Course of Study Degree or Certificate Completion Date

 

Employment History
List jobs you have held which contribute to committee qualification.

Name of Employer Location of Employer Position or Type of Work Dates Worked

Is your expertise primarly in:   plumbing   mechanical   both?

 

Related Activities and Experience
Include past committee experience, chapter activities, professional memberships, registrations, licenses, etc.

 
Signature (Required)

Your typed name above constitutes your electronic signature.
This application must be signed by the applicant. Please type your signature exactly as it appears above in the name field.

 

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