Voices Under 40 Application

Name(Required)
If selected, it will be used on our website and any publication related to this recognition.
Accepted file types: jpg, gif, png, Max. file size: 128 MB.

Commitment to Advancing our Profession through Leadership

Involvement in committees and task forces at any level of ASCLS (national, region, or state). Do not include scientific assembly or forum membership unless you are an active leader in said SA or forum. (2 points for each year of service as Past Chair, Chair, and Vice Chair. 1 point for each year for membership. Max of 20 points). List title, committee, and dates of service (most recent to oldest) at any level of ASCLS below.
Click the "+" sign to add additional positions.
Leadership in other professional organizations List organization, position and year(s) of term. NOTE that “member” in a professional organization does not qualify as evidence of “leadership”. Examples of societies: ADLM, ASM, ASM, ASCP List title, activity, organization, and year (most recent to oldest) below. (1 point for each year of service. Max of 20 points)
Click the "+" sign to add additional positions.
Workplace leadership achieved through volunteering on other professional committees or boards or through leadership outside of the medical laboratory field or your job-specific duties. List title, activity, organization, and year (most recent to oldest) below. (1 point for each year of service. Max of 10 points)
Click the "+" sign to add additional positions.

Commitment to Advancing our Profession through Education

Professional presentations and posters at any scientific meetings or events as well as any publications. (1 point for each. Max of 20 points)
List title, sponsor publisher or journal, dates, and hours (most recent to oldest).
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Commitment to Advancing our Profession to the Public through Public Relations and Professional Legislative Advocacy

Presentations or volunteer efforts that focus on promoting the laboratory to non-laboratorians-ie blood drives, career fairs, letters to or meetings with senators and representatives, coordination of proclamation of Lab Week at any level of government. (1 point for each. Max of 20 points)
List activity and year (most recent to oldest).
Click the "+" sign to add additional positions.

Community Involvement

Participation in church, community or civic organizations. List organization, position and year(s) of term. (2 points for leadership role, 1 point for activities each. Max of 10 points)
List title, activity, organization and year (most recent to oldest).
Click the "+" sign to add additional positions.

Awards, Honors and Recognitions

List any awards, honors, or recogntions you have received. (1 point each. Max of 5 points)
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Personal Statement

Please briefly answer the following questions. 3-5 sentences minimum per question.