Northern California Regional Resource Pool Form

 

The Regional Resource Pool (RRP) is a database containing contact information, service history, relevant skills, and availability of NA members who have expressed an interest in volunteering for projects or “task-based” service on behalf of the NCRSC.  The RRP will also be used as a resource for identifying potential candidates to stand for election to various Regional services positions.

Please fill out as completely as possible and
click the "Submit by E-mail" button at the bottom.

Today's Date:
Name:
Area
Clean Date:
Email:
Telephone:
Alternate Telephone:


May we contact you by email and/or telephone for either of the following regional service opportunities?


Yes, contact me about projects & presentations.
Yes, contact me about open regional service positions.
Yes, Contact me about volunteering opportunities at NCCNA.

General Questions:

I have adequate and reliable transportation to the regional service office in Fairfield and other locations throughout the region?
Yes No

(Answering “no” does not automatically preclude you from involvement in project or task-based service. Please indicate below any extenuating circumstances that may inhibit your ability to travel. Please note that all authorized travel will be reimbursed by regional services in accordance with the rates set in the current RSC travel policy.)

Please indicate below any extenuating circumstances that may inhibit your ability to travel:


I am generally available to do service on weekends, particularly on Saturdays? Yes No

I am generally available to do service on weekdays? Yes No



I am interested in considering election to one of the following regional service positions:


NCRSO Board of Directors (4 years clean) NCCNA (4 years clean)
H & I Coordinator (3 years clean) PR Coordinator (3 years clean)
RSC Chair (4 years clean) RSC Vicechair (3 years clean)
RSC Treasurer (4 years clean) RSC Assistant Treasurer (3 years clean)
RSC Secretary (3 years clean) Regional Delegate (RD) (8 years clean)
Alternate Delegate (8 years clean) Regional Nominations Panel (4 years clean)
Other:  

My Service History:
 (check all that are applicable)

Group Service:


Group Secretary Group Treasurer
GSR Refreshments / Literature Person
Other:


Area Service:


GSR ASC Secretary
ASC Treasurer ASC Chair/Vice Chair
ASC Subcommittee Chair/Vice chair PR/PI Subcommittee Service
Literature Person/Coordinator/Committee

H&I Subcommittee Service
RCM Events/Activities Subcommittee Service
Outreach Subcommittee Service Other:

Regional Service:


RCM RSC Secretary
RSC Treasurer/Assistant Treasurer RSC Chair/Vice Chair
H & I Coordinator PR Coordinator
RSO Board of Directors NCCNA
Regional Delegate/Alternate Delegate Regional Nominations Panel (RNP)
Project/Task Group: Fire Camp Project
Other:    

World Service:


Regional Delegate/Alternate Delegate HumanResource Panel (HRP)
World Board Member (WB) WSC Co-Facilitator
Pre 1998 WSC Boards/Committees (specify)
Other

My Skills and Strong Points:


Activities/Events Planning & Organizing Secretarial/Administrative
Communications/Speech/Presentation Chairperson/Facilitator
Accounting/Finance Web/Internet Technology
Multimedia - A/V Development Literature/Writing Skills
Speak/Read/Write in Languages Other Than English Please Specify Language:
Other (please specify):

Thank you for your pool form submission!

You should receive a confirmation reply shortly.