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Committee Membership Form Questions
This is an example of a committee membership questionnaire. You cannot respond to this example version of the online form.
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This committee membership sample includes these items:
What are your interests in serving on a committee?
What are your interests in serving on a committee?
Please tell us what experiences or abilities you are able to offer for committee service.
Please tell us the amount of time you are able to offer to committee service.
Are you interested in serving on a local committee only, a national committee only, either a local or national committee, or both local and national committees.
How far would you be willing to travel to attend an annual committee meetings?
How long have you been a member of the association?
What type of association membership do you currently hold?
Please share with us any additional information or comments about committee service.
Would you like to be contacted about serving on a committee?
Please provide us with your full name and contact information, including mailing address, e-mail, and telephone number.
1) What are your interests in serving on a committee?
-- Select Here --
Very Interested
Uncertain, please contact me about committee opportunities
Not interested in serving at this time, perhaps in the future
No interest in serving on a committee now or in the future (skip to Question 7)
2) Please tell us what committee(s) you would be interested in serving on. (Check all that apply)
Membership
Fundraising
Program Development
Conferences
Workshops
3) Please tell us what experiences or abilities you are able to offer for committee service.
4) Please tell us the amount of time you are able to offer to committee service.
-- Select Here --
1-2 hours per month
3-4 hours per month
5-6 hours per month
7-8 hours per month
9-10 hours per month
more than 10 hours per month
5) Are you interested in serving on a local committee only, a national committee only, either a local or national committee, or both local and national committees.
local only
national only
local or national
local and national
6) How far would you be willing to travel to attend an annual committee meetings?
Local area only
25-49 miles
50-100 miles
More than 100 miles
7) How long have you been a member of the association?
-- Select Here --
Less than 1 year
1-2 years
3-4 years
5-6 years
7-8 years
9-10 years
More than 10 years
8) What type of association membership do you currently hold?
Student Member
Associate Member
Full Member
Retired Member
9) Please share with us any additional information or comments about committee service.
10) Would you like to be contacted about serving on a committee?
Yes
No
11) Please provide us with your full name and contact information, including mailing address, e-mail, and telephone number.
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