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03-31 NASD Informs Members of Upcoming District Committee and District Nominating Committee Elections

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INFORMATIONAL

District Elections

SUGGESTED ROUTING

KEY TOPICS

Legal & Compliance
Operations
Registration
Senior Management

District Elections

Executive Summary

The purpose of this Special Notice to Members is to inform members of the upcoming nomination and election process to fill forthcoming vacancies on the District Committees and the District Nominating Committees.

Information on District Committee and District Nominating Committee members serving through 2004, 2005, and 2006 is included in Attachment A. Information on District Election Procedures is included in Attachment B. A candidate profile sheet is included in Attachment C.

Nomination Process

Individuals from member firms of all sizes and segments of the industry are encouraged to submit names for consideration for membership on the 11 District Committees and District Nominating Committees. Members are requested to submit candidates' names to the appropriate District Nominating Committee Chairman or to the District Director by submitting a cover letter and the candidate profile sheet (Attachment C) by July 28.

Completed forms will be provided to all District Nominating Committee members for review. It is anticipated that the District Nominating Committees will certify their nominees to the District Committees on or about September 12.

Members are reminded of the importance to accurately maintain their Executive Representative name and email address information, as well as their firm's main postal address. This will ensure that member mailings, such as election information, will be properly directed. Failure to keep this information accurate may jeopardize the member's ability to participate in District elections as well as other member votes. To update the Executive Representative name and e-mail address, firms should access their NASD Member Firm Contact Questionnaire (NMFCQ) located on the NASD Web Site (www.nasdr.com/disclaimer.asp).

To update postal address information, the firm must file a Form BD Amendment via the Web CRD system. For assistance updating either of these systems, you may contact our Call Center at (301) 590-6500.

Questions/Further Information

Questions concerning this Special Notice may be directed to the District Director noted or to Barbara Z. Sweeney, Senior Vice President and Corporate Secretary, NASD, at (202) 728-8062 or via e-mail at barbara.sweeney@nasd.com.


Attachment A

District 1 Committee And District Nominating Committee Members

Elisabeth P. Owens, District Director
525 Market Street, Suite 300, San Francisco, CA 94105      (415) 882-1201

District 1 Committee — Chair: S. Katherine Campbell

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
Steven R. Aaron J.P. Morgan Securities San Francisco, CA
S. Katherine Campbell Protected Investors of America Kensington, CA
Carol Van Bruggen Financial Telesis, Inc. Sacramento, CA
Committee members to serve until January 2005
Gerard P. Gloisten GBS Financial Corporation Santa Rosa, CA
Allan L. Herzog Prudential Securities, Inc. San Francisco, CA
Robert A. Muh Sutter Securities, Inc. San Francisco, CA
Committee members to serve until January 2006
Warren E. Gordon Charles Schwab & Co., Inc. San Francisco, CA
William P. Hayes Wells Fargo Investments, LLC San Francisco, CA
Francis X. Roche, II RBC Dain Rauscher, Inc. San Francisco, CA

District 1 Nominating Committee — Chair: Glenn M. Colacurci

Committee members to be elected to terms expiring January 2004: 5

Committee members
Sally G. Aelion Emmett A. Larkin Company, Inc. San Francisco, CA
Glenn M. Colacurci Salomon Smith Barney San Francisco, CA
James D. Klein UBS PaineWebber, Inc. San Francisco, CA
Jerry D. Phillips RBC Dain Rauscher, Inc. San Francisco, CA
William A. Svoboda Morgan Stanley Dean Witter, Inc. Palo Alto, CA

District 2 Committee And District Nominating Committee Members

Lani M.Sen Woltmann, District Director
300 South Grand Avenue, Suite 1600, Los Angeles, CA 90071 (213) 613-2601

District 2 Committee — Chair: Steven K. McGinnis

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
James E. Biddle The Securities Center Incorporated Chula Vista, CA
Chris M. Kanoff Jefferies and Co., Inc. Los Angeles, CA
Steven K. McGinnis National Planning Holdings Santa Monica, CA
Neal E. Nakagiri Associated Securities Corporation Los Angeles, CA
Committee members to serve until January 2005
Joan A. Payden Payden & Rygel Los Angeles, CA
Joel H. Ravitz Quincy Cass Associates Los Angeles, CA
Guy W. Williams Merrill Lynch Pierce Fenner & Smith, Inc. Costa Mesa, CA
Committee members to serve until January 2006
A. William Cohen Integrated Trading and Investments, Inc. Las Vegas, NV
Don S. Dalis UBS PaineWebber Inc. Newport Beach, CA
Donna Bartlett Lawson First Allied Securities, Inc. San Diego, CA

District 2 Nominating Committee — Chair: Robert L. Winston

Committee members to be elected to terms expiring January 2004: 5

Committee members
Margaret M. Black Morgan Stanley Dean Witter Los Angeles, CA
George H. Casey Crowell Weedon & Co. Los Angeles, CA
Miles Z. Gordon Financial Network Investment Corp. Torrance, CA
Dean A. Holmes Valic Financial Advisors, Inc. Glendale, CA
Robert L. Winston American Funds Distributors, Inc. Los Angeles, CA

District 3 Committee And District Nominating Committee Members

Joseph M. McCarthy, District Director
370 17th Street, Suite 2900, Denver, CO 80202      (303) 446-3100

James G. Dawson, District Director
Two Union Square, 601 Union, Suite 1616, Seattle, WA 98101-2327      (206) 624-0790

District 3 Committee — Chair: Kathryn A. Supko

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
George T. Diachok Geneos Wealth Management, Inc. Denver, CO
John M. Rose Seattle-Northwest Securities Corporation Seattle, WA
Kathryn A. Supko Northwestern Mutual Investment Services, LLC Boise, ID
Committee members to serve until January 2005
Gregory R. Anderson TIAA/CREF Individual & Institutional Services, Inc. Denver, CO
Robert E. Frey, Jr. KMS Financial Services, Inc. Seattle, WA
John F. York Strand, Atkinson, Williams & York, Inc. Portland, OR
Committee members to serve until January 2006
Gene G. Branson Partners Investment Network, Inc. Spokane, WA
Bridget M. Gaughan SunAmerica Financial Network, Inc. Phoenix, AZ
John W. Goodwin Goodwin Browning & Luna Securities, Inc. Albuquerque, NM

District 3 Nominating Committee — Chair: Martin O. Nelson, Jr.

Committee members to be elected to terms expiring January 2004: 5

Committee members
L. Hoyt DeMers Wells Fargo Investments, LLC Seattle, WA
J. David Griswold Frank Russell Securities, Inc. Tacoma, WA
Martin O. Nelson, Jr. Martin Nelson & Co., Inc. Seattle, WA
William G. Papesh WM Funds Distributor, Inc. Seattle, WA
Anthony B. Petrelli Neidiger, Tucker, Bruner, Inc. Denver, CO

District 4 Committee And District Nominating Committee Member

Thomas D. Clough, District Director
120 West 12th Street, Suite 900, Kansas City, MO 64105      (816) 802-4708

District 4 Committee - Chair: Timothy J. Lyle

Members to be elected to terms expiring January 2007: 3

Member to be elected to term expiring January 2006: 1

Committee members to serve until January 2004
Gene M. Diederich A.G. Edwards & Sons, Inc. Overland Park, KS
Timothy J. Lyle Trusted Securities Advisors Corp. Minneapolis, MN
Pamela R. Ziermann Dougherty & Company LLC Minneapolis, MN
Committee members to serve until January 2005
William R. Giovanni Ameritas Investment Corp. Lincoln, NE
Frank H. Kirk Wachovia Securities, Inc. Kansas City, MO
James H. Warner The Warner Group Sioux City, IA
Committee members to serve until January 2006
Deborah M. Castiglioni Cutter & Company, Inc. Chesterfield, MO
Terry L. Lister Cambridge Investment Research, Inc. Fairfield, IA
Vacancy*    

* This vacancy was created by the resignation of Richard J. Miller.

District 4 Nominating Committee — Chair: Norman Frager

Committee members to be elected to terms expiring January 2004: 5

Committee Members
Norman Frager Flagstone Securities, LLC St. Louis, MO
E. John Moloney Maloney Securities Co., Inc. St. Louis, MO
Rodger O. Riney Scottrade, Inc. St. Louis, MO
Jeffrey A. Schuh Wells Fargo Investment Services Minneapolis, MN
Gail Werner-Robertson GWR Investments, Inc. Omaha, NE

District 5 Committee And District Nominating Committee Members

Warren A. Butler, Jr., District Director
1100 Poydras Street, Energy Centre, Suite 850, New Orleans, LA 70163      (504) 522-6527

District 5 Committee — Chair: David W. Wiley, III

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
David A. Knight Stephens Inc. Little Rock, AR
Lawrence J. Sisung, Jr. Sisung Securities Corporation New Orleans, LA
David W. Wiley, III Wiley Bros., Aintree Capital, LLC Nashville, TN
Committee members to serve until January 2005
John J. Dardis Jack Dardis & Associates, Ltd. Metairie, LA
J. Timothy Rice Rice, Voelker, LLC Covington, LA
James T. Ritt Morgan Keegan & Company, Inc. Memphis, TN
Committee members to serve until January 2006
Victor E. Blaylock BancorpSouth Investment Service, Inc. Jackson, MS
Carolyn R. May Benchmark Investments, Inc. Arkadelphia, AR
F. Eugene Woodham Sterne, Agee & Leach, Inc. Birmingham, AL

District 5 Nominating Committee — Chair: Duncan F. Williams

Committee members to be elected to terms expiring January 2004: 5

Committee members
Carl W. Busch Prudential Securities Incorporated Edmond, OK
E. Douglas Johnson, Jr. Johnson Rice & Company New Orleans, LA
James M. Rogers J.J.B. Hilliard, W.L. Lyons, Inc. Louisville, KY
William L. Tedford, Jr. Stephens Inc. Little Rock, AR
Duncan F. Williams Duncan-Williams, Inc. Memphis, TN

District 6 Committee And District Nominating Committee Members

Virginia F.M. Jans, District Director
12801 N. Central Expressway, Suite 1050, Dallas, TX 75243 (972) 701-8554

District 6 Committee — Chair: R. Dwayne Whitehead

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
Christopher R. Allison M.E. Allison & Co., Inc. San Antonio, TX
David W. Turner Wachovia Securities, Inc. Ft. Worth, TX
R. Dwayne Whitehead Coastal Securities L.P. Houston, TX
Committee members to serve until January 2005
Donaldson D. Frizzell First Command Educational Foundation Fort Worth, TX
Sennett Kirk, III Kirk Securities Corporation Denton, TX
V. Keith Roberts VALIC Financial Advisors Houston, TX
Committee members to serve until January 2006
Brent T. Johnson IFG Network Securities, Inc. Houston, TX
John R. Muschalek First Southwest Company Dallas, TX
Robert L. Nash SWS Securities, Inc. Dallas, TX

District 6 Nominating Committee — Chair: Frederick W. McGinnis

Committee members to be elected to terms expiring January 2004: 5

Committee members
C. Ronald Baker Williams Financial Group Lubbock, TX
Robert A. Estrada Estrada Hinojosa & Company, Inc. Dallas, TX
Fredrick W. McGinnis UBS PaineWebber, Inc. Houston, TX
Edward M. Milkie Milkie/Ferguson Investments, Inc. Dallas, TX
Jim G. Rhodes Rhodes Securities, Inc. Fort Worth, TX

District 7 Committee And District Nominating Committee Members

Alan M. Wolper, District Director
One Securities Centre, Suite 500, 3490 Piedmont Road, NE, Atlanta, GA 30305      (404) 239-6128

District 7 Committee — Chair: Kenneth W. McGrath

Members to be elected to terms expiring January 2007: 3

Member to be elected to terms expiring January 2005: 1

Committee members to serve until January 2004
Kenneth W. McGrath Popular Securities, Inc. Hato Rey, PR
C. John O'Bryant, III Legg Mason Wood Walker, Inc. Raleigh, NC
Charles R. Roberts RBC Dain Rauscher, Inc. Richmond, VA
Committee members to serve until January 2005
Jeffrey P. Adams Balentine & Company Atlanta, GA
Richard G. Averitt, III Raymond James Financial Services, Inc. St. Petersburg, FL
Roark A. Young* Young, Stovall and Company Miami, FL
* Term expires January 2004-appointed to fill vacancy created by the resignation of Harold F. Corrigan.
Committee members to serve until January 2006
Joseph B. Gruber FSC Securities Corporation Atlanta, GA
Dennis S. Kaminski Mutual Service Corporation West Palm Beach, FL
James A. Klotz First Miami Securities, Inc. North Miami Beach, FL

District 7 Nominating Committee - Chair: Edward R. Hipp, III

Committee members to be elected to terms expiring January 2004: 5

Committee members
James W. Hamilton Morgan Keegan & Co. Atlanta, GA
Michael D. Hearn, Esq. Banc of America Investment Services, Inc. Charlotte, NC
Edward R. Hipp, III Legg Mason Wood Walker, Inc. Norfolk, VA
J. Lee Keiger, III Davenort & Company, LLC Richmond, VA
John W. Waechter William R. Hough & Co. St. Petersburg, FL

District 8 Committee And District Nominating Committee Members

Carla A. Romano, District Director
55 West Monroe Street, Suite 2700, Chicago, IL 60603      (312) 899-4324

William Jackson, Jr., District Director
1350 Euclid Avenue, Suite 650, Cleveland, OH 44115 (216) 592-2951

District 8 Committee — Chair: Gregory W. Goelzer

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
George E. Bates Bates Securities, Inc. Rockford, IL
Gregory W. Goelzer Goelzer Investment Management, Inc. Indianapolis, IN
Jay B. MacKenzie Prudential Securities Incorporated Grand Rapids, MI
Committee members to serve until January 2005
Bernard A. Breton Carillon Investments, Inc. Cincinnati, OH
Donald A. Carlson B.C. Ziegler and Company Chicago, IL
William K. Curtis M & I Brokerage Services, Inc. Milwaukee, WI
Gerald L. Oaks Legg Mason Wood Walker, Inc. Cincinnati, OH
Jill R. Powers Oberlin Financial Corporation Bryan, OH
Committee members to serve until January 2006
Wilbur H. Burch J.B. Hanauer & Co. Chicago, IL
Thomas M. McDonald Wayne Hummer Investments, LLC Chicago, IL
James J. Roth Pershing Division of Donaldson, Lufkin & Jenrette Securities Corporation Oak Brook, IL

District 8 Nominating Committee - Chair: Wallen L. Crane

Committee members to be elected to terms expiring January 2004: 5

Committee members
Wallen L. Crane Citigroup Global Markets, Inc. Toledo, OH
Mary D. Esser Cressman Esser Securities, Inc. Naperville, IL
Wayne F. Holly Sage, Rutty & Co., Inc. Rochester, NY
L. Gene Tanner NatCity Investments, Inc. Indianapolis, IN
Rodney Trautvetter Harris Investor Services, LLC Chicago, IL

District 9 Committee And District Nominating Committee Members

John P. Nocella, District Director      1835 Market Street, Suite 1900, Philadelphia, PA 19103      (215) 963-1992

Gary K. Liebowitz, District Director      581 Main Street, 7th Floor, Woodbridge, NJ 07095      (732) 596-2025

District 9 Committee — Chair: Jerry V. Duhovic

Members to be elected to terms expiring January 2007 3

Member to be elected to terms expiring January 2005 1

Committee members to serve until January 2004
Jerry V. Duhovic Ameritrade, Inc. Bellevue, NE
Kimberly Tillotson Fleming Hefren-Tillotson, Inc. Pittsburgh, PA
Howard B. Scherer Janney Montgomery Scott LLC Philadelphia, PA
Mark Thomas Whaley RBC Dain Rauscher Inc. Florham Park, NJ
Committee members to serve until January 2005
James E. Bickley Cresap, Inc. Radnor, PA
Michael B. Row Pershing Division of Donaldson, Lufkin & Jenrette Securities Corporation Jersey City, NJ
Michael S. Mortensen* PNC Investments Pittsburgh, PA
* Term expires January 2004-appointed to fill vacancy created by the resignation of Frank D. Ruscetti.
Committee members to serve until January 2006
Robert M. Berson Ryan, Beck & Co., LLC Livingston, NJ
Richard Grobman Fahnestock & Co., Inc. Philadelphia, PA
W. Dean Karrash Rutherford, Brown & Catherwood, LLC Philadelphia, PA

District 9 Nominating Committee — Chair: A. Louis Denton

Committee members to be elected to terms expiring January 2004: 5

Committee members
A. Louis Denton Philadelphia Corporation for Investment Services Philadelphia, PA
James D. Lamke Spear, Leeds & Kellogg New York, NY
Lance A. Reihl 1717 Capital Management Co. Berwyn, PA
Lenda P. Washington GRW Capital Corporation Washington, DC
Gregory R. Zappala J.P. Morgan Securities Cranberry Township, PA

District 10 Committee And District Nominating Committee Members

Cathleen F. Shine, District Director
One Liberty Plaza, 49th Floor, 165 Broadway, New York, NY 10006      (212) 858-4180

District 10 Committee — Chair: Charles V. Senatore

Members to be elected to terms expiring January 2007: 4

Member to be elected to terms expiring January 2005: 1

Committee members to serve until January 2004
Ruth S. Goodstein UBS PaineWebber Inc. New York, NY
Patrick Remmert Credit Suisse First Boston Corporation New York, NY
Charles V. Senatore Fidelity Risk Oversight Group, FMR Corporation New York, NY
Jeffrey R. Zuckerman Salomon Smith Barney Inc. New York, NY
Committee members to serve until January 2005
Jennifer A. Connors ITG Inc. New York, NY
Christopher R. Franke* J.P. Morgan Securities Inc. New York, NY
Joan E. Hoffman Deutsche Banc A.G. New York, NY
Bertram J. Riley Sr. Petersen Investments, Inc. New York, NY
Mark W. Ronda Fahnestock & Co. Inc. New York, NY
* Term expires January 2004-appointed to fill vacancy created by the resignation of Nathalie P. Maio.
Committee members to serve until January 2006
Raymond C. Holland, Sr. Triad Securities Corp. New York, NY
Vicki Z. Holleman Loeb Partners Corporation New York, NY
Andrew H. Madoff Bernard L. Madoff Investment Services LLC New York, NY
Richard J. Paley Fox-Pitt, Kelton Inc. New York, NY

District 10 Nominating Committee — Chair: Tom M. Wirtshafter

Committee members to be elected to terms expiring January 2004: 5

Committee members
Kevin J. Browne Banc of America Securities New York, NY
Judith R. MacDonald Rothschild, Inc. New York, NY
Eugene A. Schlanger Nomura Holding America, Inc. New York, NY
Stephen C. Strombelline Barclays Capital Inc. New York, NY
Tom M. Wirtshafter AXA Advisors, LLC New York, NY

District 11 Committee And District Nominating Committee Members

Frederick F. McDonald, District Director
260 Franklin Street, Suite 1600, Boston, MA 02110      (617) 261-0805

District 11 Committee — Chair: John I. Fitzgerald

Members to be elected to terms expiring January 2007: 3

Committee members to serve until January 2004
John I. Fitzgerald Leerink Swann & Company Boston, MA
Robert V. Rodia People's Securities, Inc. Bridgeport, CT
Gregory D. Teese Equity Services, Inc. Montpelier, VT
Committee members to serve until January 2005
Michael C. Braun Moors & Cabot, Inc. Boston, MA
Andrew F. Detwiler Vandham Securities Corp. Plymouth, MA
Thomas J. Horack John Hancock Life Insurance Company Boston, MA
Committee members to serve until January 2006
Mark R. Hansen State Street Global Markets, LLC Boston, MA
Gregg A. Kidd Pinnacle Investments, Inc. East Syracuse, NY
Lee G. Kuckro Advest, Inc. Hartford, CT

District 11 Nominating Committee — Chair: Stephen O. Buff

Committee members to be elected to terms expiring January 2004: 5

Committee members
Stephen O. Buff Fleet Securities, Inc. Boston, MA
Richard J. DeAgazio Boston Capital Services, Inc. Boston, MA
John D. Lane Lane Capital Markets LLC Fairfield, CT
Dennis R. Surprenant Cantella & Co., Inc. Boston, MA
Peter T. Wheeler Commonwealth Financial Network Waltham, MA

ATTACHMENT B

District Election Procedures for District Committees and District Nominating Committees

Regular Election

1. Each NASD District shall maintain a District Nominating Committee in the manner specified in Article VIII of the By-Laws of NASD Regulation, Inc.
2. The Secretary of NASD Regulation will notify in writing the Chairman of each District Committee and the Chairman of the District Nominating Committee of the upcoming vacancies on both the District Committee and the District Nominating Committee, and the procedures to follow to fill the vacancies. A copy of these letters will be provided to the District Directors.

The District Nominating Committee will be provided by NASD Regulation staff with information considered relevant to the nominating process, including statistical data pertaining to the District membership.
3. The Secretary of NASD Regulation will remind all members of their responsibility and obligation to keep current and accurate information on their Executive Representatives and branch office addresses. This reminder will contain a reference to the NASDR Web Site (www.nasdr.com) and detail the process for changing a firm's Executive Representative. Please note that failure to keep this information accurate may jeopardize the member's ability to participate in District elections as well as other member votes.
4. The Secretary of NASD Regulation on behalf of the District Committee Chairmen will send a Notice to Members announcing the forthcoming elections to the Executive Representative and each branch office of all members eligible to vote in that District. The Notice to Members will contain: a) the number of vacancies for each District; and b) the remaining members of each District Committee. Members interested in serving on the District Committee or District Nominating Committee will be requested to complete the candidate profile sheet and submit it to the District Nominating Committee Chairman or the District Director. The completed candidate profile sheet will be provided to all Nominating Committee members for review.
5. The District Nominating Committee will endeavor to secure appropriate and fair representation on the District Committee and on the District Nominating Committee of the various sizes and types of NASD members engaged in the investment banking or securities business within the District.
6. The District Nominating Committee will review the background and qualifications of the proposed candidates and the profile information provided by staff, and will determine its slate of candidates for the election.
7. On or about September 12, 2003, the District Nominating Committee will certify to the District Committee each candidate nominated by the District Nominating Committee.
8. Within five (5) calendar days after this certification, a Notice to Members shall be sent to Executive Representatives communicating the nominees for the vacancies on the District Committees and District Nominating Committees.
9. If an officer, director, or employee of an NASD member is interested in being considered as an additional candidate by contesting the election, he/she must indicate his/her interest to the District Director within fourteen (14) calendar days of the date of the Notice to Members referenced in #8 above. The District Director shall make a written record of the time and date of such notification and the process will continue as described in #10 - #13.

If an additional candidate does not come forward within 14 days, the election of committee members is complete.
10. The Secretary of NASD Regulation shall provide a list of all NASD members eligible to vote in the District and their Executive Representatives to the additional candidate(s) immediately following receipt of the additional candidate's notice by the District Director.
11. Additional candidate(s) may be nominated if a petition signed by the Executive Representative of at least 10 percent of the members eligible to vote in the District is filed with the District Nominating Committee within 30 calendar days from the mailing date of the list referenced in #10 to the additional candidate(s).
12. If no additional candidate(s) are nominated within the 30-calendar day period, then the candidates nominated by the District Nominating Committee shall be considered duly elected, and the District Committee shall certify the election to the Board of Directors of NASD Regulation.
13. If any additional candidate(s) are nominated, the procedures outlined in the Contested Election Procedures will apply.

Additional information pertaining to the District Election Procedures can be found in Article VIII of the By-Laws of NASD Regulation.

Candidate Profile Sheet

Current Employment

  Date:      
Name:   CRD#:  
Firm:   #RRs at Firm:  
Title/Primary Responsibility:
 
Address:  
City:   State:   Zip:  
Phone:   Fax:  
E-mail:  
Prior Employment (List the most recent first. Feel free to include extra pages if necessary.)
Firm:  
Title/Primary Responsibility:  
Firm:  
Title/Primary Responsibility:  

General Areas of Expertise (please check all that apply) Product Expertise (please check all that apply)
• Compliance/Legal • Investment Advisory • Corporate Bonds • Investment Company
• Corporate Finance • Retail Sales • Direct Participation • Options
• Financial/Operational • Trading/Market Making • Programs • Variable Contracts Securities
• Institutional Sales • Other • Equity Securities • Other
    • Municipal/Government Securities  
       
       

Memberships/Positions Held in Trade or Business Organizations
 
 
 
Past NASD Experience and Dates of Service (please check all that apply)
Committee Member (Identify committee:) Approx. Dates:
Arbitrator Approx. Dates:
Mediator Approx. Dates:
Expert Witness (arbitrations; disciplinary proceedings): Approx. Dates:
Other: Approx. Dates:
Educational Background
School: Degree:
School: Degree:


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