1. QUALIFICATIONS OF APPLICANT
a. Attach separate statement resumé providing evidence of your general knowledge and competence in the scope (work) of the committee.
b. What is your specific relationship to one or more elements of the scope of the committee?
c. Will you be able to actively participate in the work of the committee including responding to correspondence and attending committee meetings?
a. Indicate below the name of the entity you would be representing and include written authorization from that entity authorizing you to be their representative:
b. Does the organization you would represent have a mechanism for instructing votes? If so, can the time constraints imposed by the Regulations Governing Committee Projects be met?
3. FUNDING SOURCE(S) FOR YOUR PARTICIPATION
a. What person(s) or organization(s) would fund your participation as a committee member, either in whole or in part? (You should list your employer if your participation is funded by your employer or if your participation is part of your employment responsibilities or otherwise related to your employment.)
b. Background and description of your employer and/or other person(s) or organization(s) funding participation:
4. ADDITIONAL COMMENTS
Languages, other than English:
COMPLETE A SEPARATE APPLICATION FORM FOR EACH COMMITTEE ON WHICH YOU DESIRE TO SERVE. IN ORDER TO
ASSURE THE PROMPT PROCESSING OF YOUR REQUEST, PLEASE BE SURE TO COMPLETE ALL QUESTIONS AND SIGN
(a) Manufacturer: A representative of a maker or marketer of a product, assembly or system, or portion thereof, that is affected by the standard (e.g., manufactures of particular products and association of manufacturers).
(b) User: A representative of an entity that is subject to the provisions of the standard or that voluntarily uses the standard (e.g., educator, skill-trade trainer, skill trades person and academia).
(c) Installer/Maintainer: A representative of an entity that is in the business of installing or maintaining a product, assembly or system affected by the standard (e.g., contractors, subcontractor, and construction labor organization)
(d) Research/Standards/Testing Laboratory: A representative of an independent research organization; an organization that develops codes, standards or other similar documents; or an independent testing laboratory (e.g., code development organizations, certification agency, testing laboratory).
(e) Enforcing Authority: A representative or an agency or an organization that promulgates and/or enforces standards (e.g., regulatory agency, inspectors and enforcers).
(f) Consumer: A person who is, or represents, the ultimate purchaser of a product, system, or service (e.g., end user of a product and distributor).
(g) General Interest: A person or organization interested in the products or standard addressed by the Committee, who is qualified to serve on the committee, and who does not fall under the other categories (e.g., consultants, special experts, or engineers).
If appointed, I agree to abide by the rules and guidelines of IAPMO. In addition, I hereby agree to notify the Secretary of
the IAPMO Standards Council of a change in status, including change of employment, organization represented, or funding
source. I also agree that IAPMO shall have, and I hereby grant, all and full rights in copyright in any material that I
author, either individually or with others, as a member of this committee, or that I submit for the proposed use of the
committee in an IAPMO code or standard or other IAPMO document. I further acknowledge that I acquire no rights in
any publication of IAPMO and that copyright and all rights in all materials produced by IAPMO technical committees are
owned by IAPMO and that IAPMO may register copyright in its own name.
I do not now hold and I do not intend to hold any patent, the use of which would be required for compliance
with any material that I author – either individually or with others – as a member of this committee, or that I
submit for the proposed use of the committee in an IAPMO code or standard or other IAPMO document.
I attest that all of the information on this application is true and accurate.
By signing below, I attest to my ability to communicate with IAPMO staff and the members of the
Technical Committee through electronic means, namely via e-mail and the internet.
Your typed name above constitutes your electronic signature.
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