ASTSA Student Manual

7 Appendix A Curriculum Vitae All Information Must Be Completed – Incomplete Document Will Not Be Accepted Date : _________________________ Name: ________________________________________________________________________ Address: ______________________________________________________________________ City: _______________________ State: _______ Zip Code: _________________________ Phone: ______________________________ E-Mail: _________________________________ AST Member Student Number: ___________ Date(s) of AST Membership: _______________ Program Name: ________________________________________________________________ Program Address: _______________________________________________________________ City: _______________________ State: _______ Zip Code: __________________________ Program Director: ______________________________________________________________ Program Director Phone #: ___________ Program Director E-Mail: ______________________ Involvement in State Assembly: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Volunteer Community Involvement Name of Organization/Committee: _________________________________________________ Number of Years on Committee: _______________ Committee Function: ____________________________________________________________ Role on Committee: _____________________________________________________________