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STANDARDS COMMITTEE MEMBERSHIP APPLICATION
(Full address including city, state, zip etc.)


QUALIFICATIONS OF APPLICANT
Evidence of general knowledge and competence in the scope (work) of the Committee
Specific relationship of applicant to one or more elements of the scope of the Committee
Participation in the work of the Committee including responding to correspondence and attending Committee meetings


REPRESENTATION


FUNDING
(You should list your employer if your participation is funded by your employer or if your participation is part of your employment responsibilities or otherwise related to your employment.)
Interest Categories







  • Manufacturer: a representative of a maker or marketer of a product, assembly or system, or portion thereof, that is affected by the standard (e.g., manufacturers of particular products and association of manufacturers).

  • User: a representative of an entity that is subject to the provisions of the standard or that voluntarily usesthe standard (e.g., educator, skill-trade trainer, skill trades person and academia).

  • Installer/Maintainer: a representative of an entity that is in the business of installing or maintaining a product, assembly orsystem affected by the standard (e.g., contractors,subcontractor, and construction labor organization).

  • Research/Standards/Testing Laboratory: a representative of an independent research organization; an organization that develops codes, standards or other similar documents; or an independent testing laboratory (e.g., code development organizations, certification agency, testing laboratory).

  • Enforcing Authority: a representative or an agency or an organization that promulgates and/or enforces standards (e.g., regulatory agency, inspectors and enforcers).

  • Consumer: a person who is, or represents, the ultimate purchaser of a product, system, or service (e.g., end user of a product and distributor).

  • General Interest: A person or organization interested in the products or standard addressed by the committee, who is
    qualified to serve on the committee, and who does not fall under the other categories (e.g., consultants, special experts,
    or engineers).
Member Category



If an alternate member, please provide name
ADDITIONAL COMMENTS
Please list any committees you would like to be REMOVED from.
Conflict of Interest

You are obligated to declare any actual or potential conflicts of interest.

You agree to comply with the rules defined by ASSE including those related to confidentiality and independence from commercial and other interests.

You shall declare immediately any prior or present association on your own part, or on the part of your immediate family or employer, with any Applicant, agent, supplier, employee, owner, or member thereof. You shall also declare herewith any prior or present association on your own part, or on the part of your employer or immediate family with any ASSE recognized school, proctor, or instructor. You shall not be assigned to evaluate entities for certification, listing, or recognition for a period of two (2) years after the conclusion of such.

Please declare any entity which could contribute to any potential conflict of interest (Entity Name and Date of Association)

ACKNOWLEDGEMENT

If appointed, I agree to abide by the rules and guidelines of ASSE International. In addition, I hereby agree to notify the ASSE standards coordinator of a change in status, including change of employment, organization represented, or funding source. I also agree that ASSE International shall have, and I hereby grant, all and full rights in copyright in any material that I author, either individually or with others, as a member of this committee, or that I submit for the proposed use of the committee in an ASSE International standard or other ASSE International document. I further acknowledge that I acquire no rights in any publication of ASSE International and that copyright and all rights in all materials produced by ASSE International committees are owned by ASSE International and that ASSE International may register copyright in its own name.

I do not now hold and I do not intend to hold any patent, the use of which would be required for compliance with any material that I author – either individually or with others – as a member of this committee, or that I submit for the proposed use of the committee in an ASSE International standard or other ASSE International document.

I attest that all of the information on this application is true and accurate.  I attest to my ability to communicate with ASSE International staff and the members of the Standards Committee through electronic means, namely via e-mail and the internet.

I attest that all of the information on this application is true and accurate.
DATA ACKNOWLEGEMENT

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ASSE INTERNATIONAL

AGREEMENT POLICIES

In the course of your service on an ASSE committee, you may have access to confidential materials submitted by persons or entities seeking ASSE certification, or
approval (“Applicants”). This Confidentiality Agreement governs your responsibility with respect to those documents.

As an ASSE International (ASSE) employee, agent, contractor, subcontractor or committee member you agree to use all confidential information received from any
Applicant, its directors, officers, employees or agents including, without limitation, any confidential training materials, presentations, curriculum, designs, layouts, or any other confidential business matters relating to applicant (collectively, the "Data"), solely only in connection with the required evaluations to be performed in the course of your service on the committee.

You shall maintain the Data in strictest confidence and shall not disclose the Data to any person (the term "'person" to be construed to the broadest sense) other than ASSE unless given the express prior written consent of applicant or as may be required by any applicable laws or regulations, subpoena from a court of law, or other court order or decree.

For purposes of this Agreement, the term Data does not include any information which (i) becomes generally available to the public other than as a result of a disclosure by you or ASSE, (ii) was available to you or ASSE on a non-confidential basis prior to its disclosure to ASSE by Applicant, its directors, officers, employees or agents, or (iii) becomes available to you or ASSE on a non-confidential basis from a source other than Applicant, its directors, officers, employees or agents, provided that such source is not bound by a confidentiality agreement with Applicant or otherwise prohibited from transmitting the Data to ASSE by an contractual, legal or fiduciary obligation.

When you serve in this role, you make a commitment to maintain impartiality and avoid bias, including bias that may arise from: self-interest, self-review, advocacy, over-familiarity, intimidation, competition, or other any other source. 

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