Name:

Address:
Street:
City: State: Zip Code:

Home Phone: Work Phone: Cell Phone:

Best time to call you:

Email Address:

What skills or interests do you have, that you would like to contribute to AIT-SCM?
Please list as many as you like:

What experience do you have? Please provide details about the organization(s) for which you have volunteered or worked, events or jobs, and your responsibilities for those events or jobs:

Please provide any additional comments or information: