Consent to Serve Form

TEXAS SOCIETY OF MEDICAL ASSISTANTS AAMA CONSENT TO SERVE FORM

AUDIT (Member)
PUBLICTY/WEBSITE (Chair/Member)
CERTIFICATION (Chair/Member)
EDUCATION (Chair)

NOMINATION (Member)
BYLAWS (Member)
PUBLIC POLICY (Chair/Member)

AWARDS (Chair/Member)
MEMBERSHIP (Member)
SCHOLARSHIP (Chair/Member)
Ad-Hoc Committee’s (as needed)

*are Required Fields

Consent to Serve Form

Consent to Serve

for the year of

Name

Credentials

Address

City

State

Zip

This number is

Phone Number

Email Address

I Am Willing To Chair The Following Committee (s)

I Am Willing To Serve On The Following Committee (s)

By signing up to serve on a committee I understand I will participate in meetings in-person or virtual and fulfill all tasks assigned by the chair and/or president. I will keep all items discussed during committee work and during TSMA Executive Board meetings strictly confidential.

Signature of Nominee

Please type your full name to represent your signature.

Date

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TEXAS SOCIETY OF MEDICAL ASSISTANTS AAMA CONSENT TO SERVE FORM