Wisconsin HOSA State Leadership Conference Evaluator Volunteer Form

HOSA State Leadership Conference Evaluator Volunteer Form

Please complete and return this form no later than March 1, 2016. Thank you for completing this form. At the end of March, you will receive a confirmation that will include your specific assignment and all necessary information. Time commitment includes an informational meeting on the day of competition at either Sunday at 5:00 pm or Monday at 8:00 am, depending upon the competitive event schedule. Events take place shortly after the informational meeting and should not require more than five hours of your time

Evaluator Information Name: Job Title:

Street Address: City, State: Zip Code:

E-mail Address:

Cell Phone Number (please include area code): Volunteer Response Please select option(s) Yes, I will judge April 10, 2016 from 5:00 to 9:00 pm Yes, I will judge April 11, 2016 from 8:00 am to 2:00 pm

I am not able to judge this year, but keep my name for future years. (Complete evaluator information only and return) Competitive Events Willing To Evaluate List top three in order of preference (see below for events per day) 1st choice 2nd choice 3rd choice Sunday: Sunday: Sunday:

Monday: Monday: Monday:

Prior experience/qualifications:

Any special considerations when making an assignment? Describe.

Please see enclosed brochure for a description of each event. (S) = Sunday Event (M) = Monday Event Biomedical Debate (S) Healthy Lifestyle (S) Nursing Assisting & Personal Care (M) Community Awareness (S) HOSA Bowl (S) Outstanding HOSA Chapter (S) CPR/First Aid & Life Support Skills (M) HOSA Happenings (S) Physical Therapy (S) Creative Problem Solving (S) Job Seeking & Interviewing Skills (M) Prepared Speaking & Speaking Skills (M) Extemporaneous Health Poster (M) Medical Assisting (M) Public Health (S) Extemporaneous Writing (M) Medical Innovation (M) Public Service Announcement (S) Health Career Display (S) Medical Photography (M) Researched Persuasive Speaking (M) Health Education (S) Medical Spelling (M) Sports Medicine (M) Biomedical Laboratory Science (M) Forensic Medicine (S) Veterinary Science (M) Return this form to Janice Atkinson Mail: Janice Atkinson Email: [email protected] Dept. of Public Instruction Fax: 608-267-9275 Attn: Janice Atkinson 125 S. Webster St. Madison, WI 53703