Student Liaison Application

Official Chartered State Affiliate for the

Current GPA *

Applicant Name: *

Missouri Society for Respiratory

Student Liaison to the MSRC Board of Directors Application

AARC Member Number: *

3. Why do you feel you would be a good student liaison to the MSRC BOD? *

Expected Date of Graduation *

Address *

1. Why do you want to be a Respiratory Care Practioner? *

Respiratory Care Program *

4. In what way would the MSRC benefit from selecting you as one of the student liaisons? *

Phone *

2. Why is the MSRC important to Missouri Respiratory Care Practitioners? *

Email: *

5. As a student liaison to the MSRC Board of Directors, what goals would you work to achieve during your appontment? *