Southeastern Michigan Chapter of Naic

SOUTHEASTERN MICHIGAN CHAPTER OF NAIC VOLUNTEER APPLICATION

Personal Information (Please check the boxes which you wish to be made public):

Name:  Home Phone:

 Street Address:  Work Phone:

 City & Zip Code:  Cell Phone:

 Email:  Fax:

NAIC Status:  Club Member NAIC member ID number  Individual Member NAIC member ID number  Lifetime Member NAIC member ID number  Youth Member NAIC member ID number  Non-member (Sorry, non-members may not serve on our board)

Employment History:

Please list any positions that you presently hold or have held in the past. Organization Position Responsibilities Time Period

Organizations:

Please list any Organizations (Fraternal, charitable, volunteer) in which you are or have been active and any positions that you held: Organization Position Responsibilities Time Period

1 Education: Institution Diploma / Degree Awarded Time Period

Skills: What is your experience in using/teaching the following forms & programs? Rate from 0 to 5, with 0 being no experience and 5 being expert. NAIC Education Forms User Skill Level Teaching Ability Stock Check List (SCL) 0 1 2 3 4 5 0 1 2 3 4 5 Stock Selection Guide (SSG) 0 1 2 3 4 5 0 1 2 3 4 5 Stock Selection Guide Report 0 1 2 3 4 5 0 1 2 3 4 5 Stock Comparison Guide (SCG) 0 1 2 3 4 5 0 1 2 3 4 5 Challenger 0 1 2 3 4 5 0 1 2 3 4 5 Portfolio Management Guide (PMG) 0 1 2 3 4 5 0 1 2 3 4 5 PERT Report 0 1 2 3 4 5 0 1 2 3 4 5 PERT-A 0 1 2 3 4 5 0 1 2 3 4 5 PERT-B 0 1 2 3 4 5 0 1 2 3 4 5 Equity Mutual Fund Check List 0 1 2 3 4 5 0 1 2 3 4 5 Equity Mutual Fund Comparison Guide 0 1 2 3 4 5 0 1 2 3 4 5 Equity Mutual Fund Trend Report 0 1 2 3 4 5 0 1 2 3 4 5 Software/Tools User Skill Level Teaching Ability NAIC Classic 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Toolkit Pro 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Stock Analyst Plus 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Portfolio Record Keeper 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Take $tock 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Club Accounting 0 1 2 3 4 5 0 1 2 3 4 5 NAIC Club Accounting Online 0 1 2 3 4 5 0 1 2 3 4 5 Online Premium Services (OPS) 0 1 2 3 4 5 0 1 2 3 4 5 MS PowerPoint 0 1 2 3 4 5 0 1 2 3 4 5 MS Excel 0 1 2 3 4 5 0 1 2 3 4 5 MS Word 0 1 2 3 4 5 0 1 2 3 4 5 MS Access 0 1 2 3 4 5 0 1 2 3 4 5 HTML 0 1 2 3 4 5 0 1 2 3 4 5 QuickBooks 0 1 2 3 4 5 0 1 2 3 4 5 WinZip 0 1 2 3 4 5 0 1 2 3 4 5 Adobe Acrobat 0 1 2 3 4 5 0 1 2 3 4 5 Desktop Publishing 0 1 2 3 4 5 0 1 2 3 4 5 Other: 0 1 2 3 4 5 0 1 2 3 4 5

2 The Future: Please circle a number, with 0 being no interest and 5 being the most interested, according to your areas of interest.

Ranking Areas of Interest 0 1 2 3 4 5 Teaching 0 1 2 3 4 5 Public Speaking 0 1 2 3 4 5 Public Relations & Publicity 0 1 2 3 4 5 Accounting & Budgeting 0 1 2 3 4 5 Organization & Planning 0 1 2 3 4 5 Writing/Presentation Creation 0 1 2 3 4 5 Web Site Design & Management 0 1 2 3 4 5 Membership & Club Services - visit new and existing clubs (club calls) 0 1 2 3 4 5 Event Registration 0 1 2 3 4 5 Planning and Staffing Events 0 1 2 3 4 5 Desktop Publishing - flyers, newsletters and postcards 0 1 2 3 4 5 Working with youth 0 1 2 3 4 5 Hospitality 0 1 2 3 4 5 Facilities 0 1 2 3 4 5 Supplies - sell NAIC products at chapter events 0 1 2 3 4 5 Librarian -catalog and track chapter-owned education materials 0 1 2 3 4 5 Class monitor - help answer individual questions at chapter classes 0 1 2 3 4 5 Management 0 1 2 3 4 5 Audio-Visual 0 1 2 3 4 5 Other

If you would like to help teach, please note the classes that interest you, given the necessary training.

 101: Introduction to Better Investing  231C: Basic Investor’s Toolkit  130: SSG (Front side)  233C: Basic NAIC Classic  130: SSG (Back side)  234C: Basic Internet Research  135: Basic SSG Judgements  331C: Advanced Investor’s Toolkit  220: Advanced Stock Selection Guide  333C: Advanced Classic (SSG) Class  334C: Advanced Internet Research  221: Portfolio Management  335C: Portfolio Management on the  110: How to Start an Investment Club Internet  115: Basic Treasurer's Workshop  232C: Basic Stock Analyst Plus  201: Advanced Treasurer's Workshop  235C: Stock Screening with Prospector  140: Mutual Fund Investing  251C: Portfolio Record Keeper  210C: NAIC Club Accounting  332C: Advanced Stock Analyst Plus  212C: Connect Your Club with the  Computer Group Internet

By signing below, I certify that the information given by me is complete and accurate.

Signature: Date:

3 NAIC CHAPTER NAME _____Southeastern Michigan Chapter______

K Code____05______Date ______STANDARD OF CONDUCT (2004-05)

As a Chapter Director, Associate/Assistant Director or teacher/volunteer and member of NAIC, I agree to serve the National Association of Investors Corporation to the best of my ability (within reasonable bounds of time, energy and knowledge available). I will willingly participate in the activities of the chapter, it’s committees, or any other special assignment to which I may be appointed. I will follow through on tasks to which I commit myself. I understand that to help the organization control costs and maintain effective communications, I should establish an account at the Better Investing Web Site to gain access to OPS, Mutual Fund Online, Volunteer Resources and electronic communications between myself and NAIC. I agree to act at all times in the best interest of the National Association of Investors Corporation as set forth in the By-Laws of NAIC. I shall be guided by the general principle that I serve as a volunteer, not accepting personal gain or credit, nor will I accept personal remuneration from participants in classes and/or club visits. I agree to promote, foster and apply the philosophy of the National Association of Investors Corporation. I will not solicit business for my personal gain when in contact with NAIC members or during participation in NAIC functions. I understand I will be reimbursed only for my expenses as provided for in my chapter’s expense policy. I understand that to retain the status of a Chapter Director, Associate/Assistant Director or teacher/volunteer, I must maintain membership in NAIC. I understand that NAIC is the owner of United States trademark registrations for many trademarks and service marks, including “NAIC,” both in plain block letters and in the well-known stylized form, and that NAIC is also the owner of United States copyright registrations for many works of original authorship, including all written and computerized material. I understand that NAIC’s trademarks and copyrighted materials cannot be used by others without the consent of NAIC. I agree to promptly report to NAIC any unauthorized use of or other violation of NAIC’s rights in its trademarks and service marks, as well as any violation of NAIC’s exclusive right to reproduce or make copies of NAIC’s copyrighted works in whole or in part, and I agree personally to respect those rights at all times during and after my service as a Chapter Director, Associate/Assistant Director or teacher/volunteer. (This is to be signed by ALL CHAPTER directors, associate and assistant directors, teachers and other volunteers, including newly elected or appointed.) By signing this, I have read the above, understand and agree to adhere to this Standard of Conduct.

Printed Name Signature Date