Membership Committee Application
Thank you for your interest in joining the Membership Committee! 

Please take a few moments to review the Ambassador-at-Large role expectations to ensure you are able to be a committed and engaged member of this committee for the duration of the 2-year term.

Once your application is reviewed by the Director of Membership and Management Manager, a member of the committee will be in touch.
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E-Mail-Adresse *
Ambassador role expectations
Name *
Email *
Phone Number *
DONA International Member ID *
Are you a DONA International Member in good standing?
[You can confirm your membership is current through your DONA International portal]
 *
Are you a Certified Doula with DONA International? *
I will be available to attend and participate in the monthly Membership Office Hour / Committee Meeting on the 3rd Wednesday of each month from 3-4:30pmEST.
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I will reply to each "welcome" email, sent by the Membership Manager, to new/returning DONA members in my region to congratulate the member and introduce myself as a point of contact.
 *
I will prompt discussions and reply to conversations on DONA Connect's "Members Center" community.
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I am able to commit to the above-mentioned expectations for a 2-year term as an Ambassador with the Membership Committee. *
Which region are you living in / applying to represent? *
Why are you interested in this position? *
Please list your relevant skills and experiences that you'll bring to the committee *
Conflict of Interest and Disclosure Form
Please disclose any conflicts of interest by writing your name in section A or elaborating in section B.
A. I am not aware of any relationship or interest or situation involving my family or myself which might result in, or give the appearance of being, a conflict of interest between such family member or me on one hand and DONA International on the other.
B. The following may be relationships, interests or situations involving me or a member of my family that I consider might result in or appear to be an actual, apparent or potential conflict of interest between such family members or myself on one hand and DONA International on the other. 

[Note: The Director of Membership will follow up with you for additional details about any potential conflicts / checked boxes]
I have read and understand DONA International’s conflict of interest policy and agree to be bound by it. I will promptly inform the President of DONA International of any material change that develops in the information contained in the foregoing statement.    *
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Committee/Contractor Non-Disclosure Agreement

It is important for all volunteers and service providers of DONA International to respect the confidential nature of documents and information learned in the course of their interaction with DONA International and other volunteers and service providers. 

Confidential Information includes all proprietary information, such as member lists, and all non-public information belonging to or about DONA International. Information should be considered non-public unless it is published on the DONA International website or distributed in written form outside of DONA International committees or governing bodies.

By signing below, you confirm your agreement to keep all Confidential Information confidential and refrain from disclosing it unless specifically authorized to do so by DONA International. 

This Agreement survives the end of any volunteer or service period for DONA International.
Consent to the Non-Disclosure Agreement
 *
Sie erhalten unter der von Ihnen angegebenen E-Mail-Adresse eine Kopie Ihrer Antworten.
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