GA HIMSS Volunteer Application
Thank you for your interest in contributing your time and talents to your GA HIMSS colleagues. Upon selection you will be asked to review and complete the chapter Conflict of Interest and Code of Ethics forms.
Email address *
Name *
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GA HIMSS Volunteer Roles
Role Definition & Expectation:
-All Roles are for a Term of 1 year (July through June)
-Individual is to be a HIMSS & GA HIMSS Member in good standing
-Individual must demonstrate active participation in role that was accepted.


Board Volunteer - Proven demonstration in leadership in the HIT Industry & GA HIMSS, available to chair a committee or event, support & attend GA HIMSS events as able, and attendance at each Board Meetings (Average 8-10 hours/month total commitment).


Committee Volunteer - Knowledgeable in area of committee focus, demonstration of team work, reliability and active participation (Average 8 hours/month total commitment).

Subject Matter Expert - Speak at an event or sit on a panel.

Event Volunteer - Demonstration of team work, reliability and active participation (Average 2-4 hours/month total commitment).

What type of role are you interested in volunteering in? *
Share why are you interested in serving in the role mentioned above? *
Your answer
Enter your LinkedIn Profile below (copy the Web address beside "Public Profile" in the main profile box at the top of the page.) *
Your answer
Indicate which committees interest you. *
Describe previous volunteer/board experience, related to interest area identified above. *
Your answer
What skills and/or experience would you bring to the chapter? *
Your answer
What is your expected availability of volunteer hours per month? Refer to http://ga.himsschapter.org/volunteer-information for estimated hours per role. *
Your answer
Company/Organization *
Your answer
Phone number *
Your answer
Address *
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Email address *
Your answer
HIMSS Member Number *
Your answer
A copy of your responses will be emailed to the address you provided.
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