Your Name


    Company


    Address


    City


    State


    Postal Code


    Phone


    E-mail

    In which sector do you perform a majority of work?

    Agriculture, ForestryConstructionEducation ServicesEnvironmental ProtectionFood ServicesGovernment/PublicHealth CareManufacturingMiningNon-profit/NGOOil and Gas ExtractionProfessional, Scientific, and Technical ServicesRemediation ServicesTransportation and WarehousingUtilitiesWaste ManagementWholesale Trade

    Other (please specify)

    I. Committee of Service for 2023

    Please select ALL committees on which you serve.

    Board of DirectorsCDGP SchemeCDGT SchemeCHMM ExaminationCHMM RecertificationCHMP SchemeFellows of Institute NominatingFinanceNominatingProfessional StandardsPublic OutreachCSHM SchemeCSMP SchemeASHMGovernment Affairs45 In 5Microcredential Task ForceAHMM SchemeSustainability Task ForceProfessional TextbookStudent CHMMCSSS-CSSMScholarship

    II. Commitment to Serve

    Committee Duties and Responsibilities

    • In executing its responsibility to achieve IHMM’s mission, Committee members, individually and collectively, shall act in good faith in all matters to assure the ongoing administration of credible credentialing programs.

    • Each committee member shall execute his or her responsibility in conformance with the Institute Bylaws, established IHMM policies and procedures, the Code of Ethics, and the Volunteer Code of Conduct.

    • Each committee member holding an Institute credential scheduled to recertify during his/her tenure may not recertify by examination, and shall submit to a mandatory full audit of their recertification application.

    • No one who is serving on a standing committee may serve as a Director.

    Meeting Participation

    • Members of all IHMM committees are responsible for participating in the meetings of the committees on which they serve.

    • Failure of committee members to participate in committee meetings may result in removal from service.

    I ACKNOWLEDGE AND CONSENT

    III. Code of Ethics

    The IHMM Code of Ethics sets forth the ethical principles to be observed by IHMM Certificants. IHMM Certificants shall, in their professional activities, sustain and advance the integrity and honor of the practice of hazardous materials management / health and safety by adherence to this Code of Ethics. IHMM Certificants who violate any provision of the Code of Ethics will be subject to disciplinary action by a peer review panel, which may result in suspension or revocation of the credential.

    1. An IHMM Certificant shall practice in a manner consistent with all applicable laws and regulations; shall demonstrate integrity, honesty, and fairness in all activities; and shall strive for excellence in all matters of ethical conduct. The designations held by the certificant may not be used by anyone for any purpose that is untruthful, misleading, or in violation of any law or government regulation. An IHMM Certificant must approach other individuals with the requisite professional balance of knowledge, skill, experience, and professionalism in the conduct of all professional activities, and in a manner free of bias with regard to religion, ethnicity, gender, age, national origin, or disability.

    2. An IHMM Certificant’s primary responsibility is to protect the public and the environment. All actions taken on behalf of a client or employer must be consistent with this primary responsibility. The interests of individual clients and employers must be secondary to protecting public health and safety, national security, and the environment.

    3. An IHMM Certificant shall act with integrity in any relationship that involves an employer or client. An IHMM Certificant has an obligation to disclose fully to an affected employer or client any conflicts of interest resulting from business affiliations or personal interests, and to maintain the security and confidentiality of an employer’s or client’s confidential information.

    4. An IHMM Certificant shall represent his or her qualifications honestly, and shall function only within his or her area and level of competence. An IHMM Certificant is expected to judge objectively his or her own level of competence, and to function within that level of personal confidence and professional expertise. When An IHMM Certificant is expected by a client or employer to function outside of his or her area or level of competence, the IHMM Certificant must seek appropriate expertise, or suggest that the client or employer find a qualified person.

    5. An IHMM Certificant shall behave with professional decorum and restraint, and shall not exhibit conduct that brings discredit on IHMM’s Certification Programs. The IHMM Certificant is a professional and must conduct themselves accordingly.

    6. An IHMM Certificant shall comply with and uphold all policies, procedures, guidelines, and requirements of IHMM; shall use their designations only as authorized by IHMM; shall acknowledge that the certificate and marks are the property of IHMM; and shall return the certificate and discontinue use of the designation and marks when required to do so by IHMM.

    An IHMM Certificant shall accept responsibility for maintaining the credential through recertification, shall remain current in the field, and shall continuously uphold the Code of Ethics.

    The IHMM Certificant acknowledges that IHMM’s Certification designations and acronyms are registered trademarks of the Institute of Hazardous Materials Management, and that he or she is authorized to use these designations only so long as the certification has not expired, been suspended, revoked or voluntarily relinquished, or converted to the Inactive or Emeritus status. The IHMM Certificant acknowledges that authorized use of Certification designations and acronyms as described in this section does not include the right to use the logo of the Institute of Hazardous Materials Management without express written permission from IHMM. An IHMM Certificant shall voluntarily and immediately report any felony convictions or other legal or disciplinary dispositions that would constitute violations of this Code of Ethics that have not already been disclosed to IHMM, regardless of when they occur. I understand that violating the Code of Ethics could lead to suspension or revocation of my IHMM certification. I also understand that if my certification lapses or is revoked for any reason, I will no longer be authorized to use the IHMM designation.

    I ACKNOWLEDGE AND CONSENT

    IV. Volunteer Non-Disclosure Agreement

    • Volunteers shall understand that in the course of performing committee service for the Institute of Hazardous Materials Management (IHMM) they may receive information or materials which are sensitive or confidential in nature.

    • Volunteers agree to maintain strict confidentiality of committee information or materials,

    • Volunteers agree that all materials relating to service for IHMM, whether they are prepared in whole or in part by the volunteer or by any other person, are and shall remain the exclusive property of IHMM.

    • Volunteers agree to return all confidential materials to the Chairperson of the committee or to the IHMM Executive Office as soon as official need for them has ended, but no later than upon the end of tenure in this volunteer position.

    • Volunteer service may be terminated by either party with 30 days advance notice in writing, or immediately upon the material breach of any of the terms and conditions contained herein.

    I ACKNOWLEDGE AND CONSENT

    V. Volunteer Code of Conduct

    This Volunteer Code of Conduct is an agreement between IHMM and individuals serving the organization, which states the
    responsibilities of volunteer service. I agree to the following conditions:

    • Volunteers must be current in all certification requirements and have a signed Code of Ethics on file with the IHMM Executive Office.

    • Volunteers shall abide by the policies and procedures of IHMM.

    • Volunteers shall understand and accept their fiduciary responsibility, and shall perform all of their duties in a manner reflective of good stewardship.

    • Volunteers shall not engage in personal and professional conflicts of interest in all matters pertaining to the business of IHMM.

    • Volunteers shall declare any potential conflict of interest to IHMM if it arises. Volunteers shall respect and protect confidential information.

    • Volunteers shall act fairly and be impartial and unbiased in their service to IHMM.

    • Volunteers shall conduct themselves in a professional manner during the conduct of IHMM business and shall treat all stakeholders with courtesy and respect.

    • Volunteers shall support the decisions of IHMM and shall not speak or act for IHMM without proper authorization.

    • Volunteers shall participate in the activities required of them to fulfill their appointed duties. Volunteers shall be advocates for IHMM and support its mission.

    • Volunteers shall acknowledge that failure to uphold and abide by the Volunteer Code of Conduct may result in removal from participation in the Volunteer Service.

    I ACKNOWLEDGE AND CONSENT

    VI. For IHMM Examination Committees

    Volunteers shall not be involved in activities that train or prepare candidates for any IHMM examination(s), or be willing to cease such activities for the duration of service on the Committee and for a period of 5 years thereafter in accordance with the latest approved IHMM policies and procedures.

    I ACKNOWLEDGE AND CONSENT

    VII.Conflict of Interest

    In the scope of work on IHMM committees, volunteers must act at all times in the best interests of IHMM and not for personal or third-party gain or financial enrichment. Volunteers have no business, professional, personal, or other interest, including, but not limited to, the representation of other clients, that would conflict in any manner or degree with the performance of its obligations in providing services to IHMM. If any such actual or potential conflict of interest arises during the course of your work on the committee[s], volunteers shall immediately inform IHMM in writing of such conflict. If in the reasonable judgment of IHMM, such conflict poses a material conflict to and with the performance of the volunteers’ obligations during the course of work on the committee[s], then IHMM may terminate the work immediately upon written notice to the volunteer; such termination shall be effective upon the receipt of such notice by IHMM.

    I ACKNOWLEDGE AND CONSENT

    VIII. Volunteer Acknowledgement

    I acknowledge that I have read and understood the information regarding my volunteer service, and agree that I will fulfill my duties and responsibilities within my committee term for 2023 I understand and agree to comply with all confidentiality and conflict-of-interest requirements of IHMM and will uphold and abide by the Code of Ethics, Volunteer Code of Conduct, Conflict of Interest and Non- Disclosure Agreement.


    Signature:

    Date: