Interest Form: ASISE
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TimestampChoose the one that appliesFirst NameMiddle NameLast NameEmail addressOther digital contact information (Facebook, Twitter, LinkedIn, Skype, etc.)Website or BlogCountryStateCityZipCurrent SchoolCurrent PositionYears in current position/schoolTotal years in educationIs your current school accredited by a state or regional association?If so, by whom is your school accredited?In what ways do you believe you can contribute to the mission of the ASISE?What function(s) would you like to see the ASISE take on as part of its operations?Specifically what role(s) do you fill?Please mark any items below with which you have experience.Use this space to elaborate on the items marked above.Would you like consideration for membership on the ASISE's Board of Leaders?Please use this space to leave any additional comments.
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