Workgroup/Committee Volunteer Application NATCO is recruiting members to actively participate on various tasks, projects and workgroups related to the Strategic Plan of NATCO. The activities of the committees/workgroups are driven by specific charges/projects identified by the Board of Directors. Workgroups are established from the committees throughout the year to work on specific projects. If you are interested in contributing your skills and are a NATCO member in good standing (membership dues are up‐to‐
date), please fill out the information below. Committee/Workgroup appointments are for a two‐year term, after two years you may resubmit the application for continued participation on the same committee or to be considered for appointment to another committee. Name/Credentials: Current Position: Institution: Address/City/State: Position: Contact Phone: Email: Date: Do you work in: Transplant Procurement Within your field, what is your area of practice? (ex. Kidney transplant, Hospital Development etc.) __________________________________________________________________________________ Let us know your areas of interest in working with NATCO: Membership (Increasing, maintaining, nurturing and sustaining membership) Collaboration/Advocacy (Working to nurture collaborative relationships with other transplant/procurement organizations Education (Maintaining and expanding education to meet the needs of our members) Communication (Expand NATCO’s social media presence and website updates) Research (Promote research and seek new resources for funding of research opportunities) Ethics (Reviewing Ethical issues related to donation and transplantation) The Committee members are assigned to complete specific NATCO project initiatives directed by the Board of Directors. E‐mails will be disseminated with requests for specific area(s) of interest to ensure that you are assigned to a workgroup which interests your personal and professional skills. Please note that not all committee members may be chosen for a workgroup, but there are other projects may arise during the year with which committee members will be asked to assist. An example is a request for comments regarding educational content at an upcoming meeting or on proposed policies or regulations issued by UNOS, The Joint Commission or the Centers for Medicare and Medicaid Services (CMS). HIGHLIGHTS: PROFESSIONAL ACTIVITIES IN TRANSPLANTATION Section 1: List NATCO Offices/ Committees/Project participation: • for years • for years • for years • for years Years of experience in donation/transplantation: Section 2: Miscellaneous Certifications: • : Dates: • : Dates: Other Association Experience: • Name: Role: Dates: • Name: Role: Dates: NATCO Executive Office PO Box 15384 Lenexa, KS 66285‐5384 913.895.4612 913.895.4652 (fax) natco‐[email protected]