DSTA Application for Committee Appointment
I have read and understand the descriptions of all DSTA committees and hereby apply for consideration as a member of the committee(s) indicated below (check all that apply):
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Awards & Recognition
Counselor - Elementary School
Counselor - Middle School
Counselor - High School
Political Action (PAC)
First & Last Name
Personal email address (not
Please check one (1)
Best contact phone number
Current grade level
List any subject(s) you've taught and the number of years you've taught them (approximate is acceptable):
Have you ever been involved in union (DSTA or other) activities in the past? Please explain in detail or indicate that this is your first experience:
List any experience/special skills that you would bring to the committee(s) for which you are applying:
Attendance and participation in relevant training in order to enhance your role as a committee member is essential. Please initial here that you understand and agree to attend (emergencies notwithstanding):
Do you wish to be considered for the position of Committee Chairperson?
Signature (type your full name as recorded by CTA):
Thank you! You will be notified individually (email or phone) of your appointment.DSTA -- 79440 Corporate Centre Drive, #116, La Quinta CA 92253 -- 760-564-3396
Send me a copy of my responses.
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