CMG Virtual Convention 2021 Survey Application Date* MM slash DD slash YYYY Which committee? (Separate application required per committee please)* Name First Last Non-CBC Email* Daytime Phone*Work location* Years employed at CBC* Current job classification* Why do you want to serve on this committee?*What experience or skills do you bring to this committee?What union positions(s) do you currently hold, if any? Other and/or previous union activity?*Have you applied for other committees at this time (Please specify)? If you were given the option, which would be your first choice?*National EAP Committee: Endorsement from a local EAP representative Is Mandatory (Please name endorser here and have endorser complete Endorsement Form). Click here for endorsment formName of endorser Other commentsNameThis field is for validation purposes and should be left unchanged.