ASCLS-WI Board Service Award Form
The purpose of this award is to recognize members who have given outstanding service to ASCLS-WI during the current year. A point system is used to determine awardees of either the Board Service Award or the Board Certificate of Recognition. ASCLS-WI Awards are presented at the annual spring convention. Please complete application by April 1.
Name *
ASCLS# *
Email *
Phone
Number of Years of Membership in ASCLS-WI *
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