Online Membership Form

Are you interested in becoming an active member of the Chancellor's Committee on the Status of Persons with Disabilities (CCSPD)? If so, please complete the following CCSPD Online Membership Form to begin receiving Important information. 

NOTE: When you are through, simply hit the "Submit" button once. Though you will not receive an automatic online confirmation, your information will be immediately sent to one of the CCSPD Co-Chairs.

        Name     

        Title        

        Address  

        City         

        State       

        ZIP         

        Phone     

        Fax         

        Email       

 

        Would you like to be on the CCSPD mailing list?
                            Yes

                            No

        Would you like to be on the CCSPD Listserv?

                            Yes

                            No

       Please share any additional information that may help us find the right volunteer placement for you. Also, if you have any CCSPD related 
        comments, concerns, or questions, do not hesitate to voice them. 

                       

 

                          

 

For more information, please contact Larry Voss at (312) 355-0550 or lvoss65@uic.edu

 

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