CBC Branch Committee Application

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 form
Name of endorser
Other comments
Name
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