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Your information Name *
* What is your relationship to Myositis? * Patient Caregiver/Care Partner Family Member or Friend Healthcare Provider/Researcher Supporter Which type of Myositis? Dermatomyositis (DM) Antisynthetase Syndrome (ASyS) Clinically Amyopathic DM Inclusion Body Myositis (IBM) Necrotizing Autoimmune Myopathy (IMNM) Polymyositis (PM) Juvenile Myositis PM or DM MCTD Other, not listed Your Employment
You may leave this section blank if included in your resume/CV. Otherwise, enter current or most recent employer.
Your Experience/Education/Training/Certifications Have you received any degrees, awards or honors that you would like to mention? Please list boards and committees that you serve on, or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social). How do you feel MSU would benefit from your involvement on the Board? * Why are you choosing to apply for a board position with MSU? * Select ALL with which you have experience * Describe your skills and experience *
Please be specific and list computer/software skills and other skills that would make you a good fit for MSU and a board member position.
Just a little more Please list any groups, organizations, or businesses that you could serve as a liaison to on behalf of MSU.
MSU does not, and will not, discriminate based on race, color, age, religion, national origin, gender, gender expression, gender identity, sexual orientation, national origin (ancestry), ethnicity, marital status, disability, or political affiliation.
MSU is committed to building a diverse, inclusive, and welcoming atmosphere. Strengthening diversity at all levels is part of our focus.
Biological Sex Female Intersex Male Gender Identity Female Male Non-binary Gender Fluid Gender Queer Gender Variant Gender non-conforming Third Gender Questioning Unknown Prefer to describe Prefer not to say Racial Classification Asian, Pacific Islander, S. Asian Bi-Racial Black Multi-Racial Native/Indigenous White Other Prefer not to answer Ethnicity Hispanic/Latin Not HIspanic/Latin Prefer not to answer How did you hear about us? *
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