*Please consider me for the following committee(s): 

Public Affairs Division ---------------------------------------- Governmental Affairs Military Affairs Cultural Diversity Transportation Committee Air Service Task Force   Rural & Community Dev. Division ---------------------------------------- Agricultural & Natural Resource Cultural Affairs Health & Human Services Leadership Rapid City* Catalyst   Organizational Dev. Division ---------------------------------------- Diplomats* Frontiers - Forging out Future Technology   Public Relations Division ---------------------------------------- Ambassadors Member Services Officials Club   Visitor Dev. Division ---------------------------------------- Convention Marketing Tourism Marketing Long Range Planning International Marketing
Use the ctrl key to make more than one selection.
*Limited Membership

*Name:			*Are you a member?
			Yes No
First	MI	Last

*Firm/Organization:

*Address:			*Phone: Fax: E-mail:
City	State	Zip Code

  I would be willing to serve where needed.

Other Comments:

*Required Information