Membership Status: (Please check choice)
1. New Member
2. CSHRM Renewing Member
3. Student Membership:
            College:   Graduation date:

Are you a member of ASHRM (American Society for Healthcare Risk Management)?
Yes     Date joined ASHRM:
No

Areas of Responsibility:

Committee Participation

I wish to serve/assist on the following committee(s)/activities:
(Please check all boxes that apply)

A. Membership Committee
Chairperson: Lisa Calafiore – lisa.calafiore@awacservices.com
1.  Recruit new members for the Society.
2.  Recommend members to the Board of Directors for approval.
3.  Initiate an annual membership drive to enhance recruiting.
4.  Develop incentives for attendance at all meetings.

B. Nominating Committee
Chairperson: Pauline Barry – Pauline.Barry@awacservices.com
1.  Initiate a general call for suggested nominees for vacant and/or expired
offices of the Society and Board.
2.  Prepare a slate of eligible candidates for each position to be sent to the membership not less than thirty (30) days prior to the annual meeting.
3.  Present the tabulation to the Board for announcement to the membership.  
4.  The members of the Nominating Committee shall be non-directors and shall be ineligible to be nominated for a directorship or office during their term on the Committee.

C. Program/Education Committee
Chairperson: Tracey Lemay – TLemay@Masonicare.org
1.  Conduct a needs assessment of the Society members on an annual basis.
2.  Develop a list of speakers/programs for each meeting on topics of interest consistent with the stated objectives of the Society.
3.  Prepare a calendar of educational programs in advance for distribution to the membership.

D. Finance Committee
Chairperson: Steve Geib – Stephen.geib@willis.com
1.  Review the finance ledger of the Society.
2.  Prepare an annual budget based on a projected budget from each of the listed committees.
3.  Make recommendations to the Board on the utilization of funds to promote the growth and education of the Society members.

E. Website and Member Resources Committee
Chairperson: Joshua Rozovsky – josh@therozovskygroup.com
1. Develop and maintain a current website to inform members of current topics of interest, legislation, education, membership news and other events.
2. Determine and recommend to the Board of Directors which resources including but not limited to books, consulting services or websites, would be most valuable to the membership.

F. Bylaws Committee
Chairperson: Eric Niederer – eric.niederer@wilsonelser.com
1. Review annually the Society Bylaws
2. Make recommendations for modification as necessary

G. New Committees Pending Approval
1. Legislative
2. Welcoming

Comments/Suggestions regarding Society activities:

Areas of special interest/suggestions for future educational programs?

Would you like to be a member of our speakers bureau or be a presenter at one of our meetings?

What can CSHRM do to better serve you as a member?

Would you like to become actively involved in CSHRM activities? What type of activities?

Are you currently serving on the Board or any committee? Yes No
If yes, in what capacity?

Can you mentor new members if needed? Yes No

Do you access the CSHRM website? Yes No

AFFILIATED WITH AMERICAN SOCIETY FOR HEALTHCARE RISK MANAGEMENT