SAPCC Alternate Representatives Contract

Welcome to the Alternate Representatives Contract page. Please return this form to: Representative Liaison by September 1st by clicking on the submit button at the bottom of the form. Additional contact information can be found in the ICES Newsletter or at www.ices.org (representatives liaison). Fields marked with an * are required Submit this form to the Representative Liaison by September 1st (Contact information can be found in the ICES Newsletter or submit online here.)

Your Information
S/A/P/C/C Name*
Please select your State, Area, Providence, Country or Chapter name.
Representatives/Ambassador's Email*
Enter Email Confirm Email
Your Name*
First Last
Phone*
Primary contact number
Alt Phone
Please enter alternate phone number if applicable.
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Photo*
Accepted file types: jpg, png, jpeg.
Please upload your High Quality Photo in JPG or PNG here. A current Head shot must be submitted with this form. Maximum Upload Size 5 MB.
Biography Upload*
Please attach a Biography (BIO) of yourself in PDF format. A current Bio must be submitted with this form. Maximum Upload Size 5 MB.
Alternate Representatives Contract
I having been elected, or appointed by the Representative Liaison, to the position of Alternate Representative of ICES for the State/Area/Province/ Country/Chapter (S/A/P/C/C) stated above, and I accept the responsibilities to help lead our members and support our organization.

The Alternate(s) shall assist the Representative and be available to perform as needed in the absence of the Representative. If a Representative is unable to complete his/her term of office, the Alternate shall assume the position of Representative until an election can be held.

By accepting this position, I am committing myself to serve this organization to the best of my ability.

I further agree to support, and promote the organization by being an active member, including participating in meetings and attending the annual conventions, if possible.

I will take these duties seriously.

I will follow directives from the Board of Directors and act on Board suggestions to the best of my ability. As an Alternate Representative, I will keep my ICES membership current during my term,

*** A current Headshot and Bio must be submitted with this form ***
Contract Digital Signature*
- Alternate Representatives Contract Signed
By Checking Contract Digital Signature, I agree to the Alternate Representative Contract and all ICES responsibilities it implies.
I Agree*
- Digital Signature
By clicking “I agree”, I agree to use an electronic signature to demonstrate my acceptance of the above information.
I understand and agree that an electronic signature and/or electronic acceptance is as legally binding as an ink signature.
A current Head shot and Bio must be submitted with this form
Al hacer clic en "Acepto" acontinuación, acepto usar una firma electrónica para demostrar mi aceptación dela información anterior.
Entiendo y acepto que una firma electrónica y / oaceptación electrónica es tan vinculante como una firma de tinta.
Se debe enviar un Head shot y una biografía actuales con este formulario.
This form is not complete unless you click “submit" and will be used as your digital signature.
Once you have submitted the form you should receive a “Thank You” confirmation email. If you do not receive this “Thank You” email then your form DID NOT go through and you will need to RE-SUBMIT your form.
Please double check to make sure you:
Have filled in all the required information, (a RED message will appear if information is missing).
Este formulario no está completo a menos que haga clic en "enviar".
Una vez que haya enviado el formulario, debe recibir un correo electrónico de confirmación de "Gracias". Si no recibe este correo electrónico de "Agradecimiento", entonces su formulario NO se envió y tendrá que REITERAR su formulario.
Por favor, vuelva a verificar para asegurarse de que:
Ha completado toda la información requerida (aparecerá un mensaje ROJO si falta información).
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Name
This field is for validation purposes and should be left unchanged.

SAPCC Alternate Representatives Contract

Your Information

Alternate Representatives Contract

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