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Contact Information
First name
Last name
Email Address
Department
Do we have permission to list your name in the public directory?
Yes
No
Committee Interests - please check all you are interested in. (optional)
Dominion Lecture Committee: implements the Dominion Lecture by identifying a speaker, actively participating in hosting the speaker, and staffing the event.
Professional Development Fund Committee: reviews applications and selects recipient(s) annually.
I am not available this year
Membership Fee
$35 - Salary greater than $50,000
$20 - Salary between $30,000 - 49,999
$10 - Salary less than $30,000
$5 - Part Time or Emeritus
Pay What You Will
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