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Osher Institute Advisory Council Application

Thank you for your interest in becoming a member of the Osher Instituteʼs Advisory Council. Please complete this application and submit it for review. This form cannot be partially filled out and saved to finish later. For longer text answers, you may draft them in another document and copy and paste them into the text areas. For more information about the Advisory Council and the nomination process please read our Advisory Council Bylaws.
Application deadline: March 1
Information with an asterisk * is required.

TODAY'S DATE:(Required)

Name and Contact Information

NAME:(Required)
ADDRESS INFORMATION:(Required)
Preferred method for written communication:(Required)

Background Information

1. You must be a current Osher member to apply. Is your membership current?(Required)
2. How long have you been an Osher member?(Required)
4. It is preferable that applicants have served in other volunteer capacities for the Osher Institute. In which of the following have you participated? (Check all that apply.)(Required)
5. The Advisory Council meets four to five times per year. Can you commit the necessary time and energy to these activities for the next three years?(Required)
6. Advisory Council members are asked to serve or lead on Osher subcommittees in addition to serving on the Council. Which committee(s) is/are of interest to you?
8. Check the following areas that are of the greatest interest to you:(Required)