Visiting Committee Membership Request Form

First Name*
Last Name*
Best contact phone number*
Best contact Email address*
County of Residence
Please select the New Hampshire county in which you live. This helps ensure that selected Visiting Committee members are geographically representative.
Organization you are representing
This includes department/agency and professional associations. If you are not representing any organization or association please enter "Public Member."
Organization Type
- Call or Volunteer
- Combination
- Career
- Association or Industry
- Public member (no organizational affiliation)
Please select the type of agency or department you have the most experience with. This helps ensure that selected Visiting Committee members are representative of the types of response agencies.
Current Visiting Committees
- Driver Operator Programs NFPA 1010 (2024 Edition)
- Interfacility Transfer (IFT) Curriculum Development
Years of relevant experience*
Please enter a number from 0 to 100.
Please provide a brief explanation of your experience and how it will benefit the visiting committee?*
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