South Central Association of Blood Banks

2901 Richmond Road, Suite 130-176
Lexington, KY 40509
Phone: (866) 649-6550 Fax: (866) 649-6590

SCABB Committee Call Form

Please complete the application below to identify the areas in which you wish to serve the association. After submitting the form to Central Office, you will be contacted by the respective Committee Chair. If you have any questions, please contact Central Office at 866-649-6550.

Name:
Email:

I would like to serve on a committee. I have indicated my preference below.
I would be willing to serve in the position of Chair or Vice-Chair

Please select your preference below by marking your First Choice with a "1", Second Choice with a "2", and so on.
Finance		Membership
Annual Meeting		Admin. Program
Donor Recruitment, P.R. Etc.		Awards
Exhibits		Education
Local Arrangements		Fund Raising
Planning		Nominating
Technical/Scientific Program		Publications
By-Laws		Industry Workshops
Protege Mentorship Program		History / Archives

I am currently a South Central Member.
I would like to become a South Central Member (Please see the Membership Section for information and an application)

Note: You must be a member to serve on a committee.

Please provide the following for the Officer and Committee Handbook.

Current Position:

Check all that apply:
Phlebotomist		SBB
Recruitment		PhD
Communications Professional		Component Production
LVN		Administration
RN		CEO
MLT		MD
MT		Other
BB

Preferred Mailing Address (please check your preference below):

Institution
Institution Name:
Institution Address:
City:
State:
Zip:
Business Phone:
Fax:
Email:

Home
Address:
City:
State:
Zip:
Business Phone:
Fax:
Email: