If you wish to become a CSDA member (or simply wish to join our organization to register support for our group and our cause – membership numbers matter when trying to get officials to listen to our concerns/issues), please read through the below CSDA membership application, fill out the first and fourth pages and either mail to Debbie Roy, CSDA President, 11512 Basswood Court, Laurel, MD 20708, or if you wish and are able, those two “filled out pages” may be scanned (or digitally photographed) and emailed to Warren at w.black@verizon.net. No dues or donation is required.
CSDA Membership Application
I, __________________________, hereby apply for membership in the Chemical Sensitivity Disorders Association (CSDA).
I agree with CSDA’s mission statement as set forth below:
The mission of the CSDA is to provide information and support to persons suffering from chemical sensitivity and related disorders; to educate government officials, academic and industry leaders, and consumer groups about the specific needs of chemically sensitive people, and to work with them to obtain information, services, and conditions that are important for the well-being of chemically sensitive people; to be a clearinghouse for relevant information concerning chemical sensitivity; to promote a deeper understanding among physicians and scientists and, in turn, the general public concerning chemical sensitivity disorders and sensitizing conditions; to encourage research on chemical sensitivity; to work to establish public policies that will curb toxic exposures and safeguard health; and to cooperate with like-minded groups.
I acknowledge that people with chemical sensitivity / chemical injury need to avoid pollution, volatile organic compounds, and the use of chemicals in their daily lives to maintain their health. Chemical sensitivity disorders also include, but are not limited to, the associated conditions of fibromyalgia, chronic fatigue, mold sensitivities, and electromagnetic sensitivity. I want to join CSDA to learn more about chemical sensitivities and to lend support to others with chemical sensitivities and to support causes / activities that may improve the lives of people with chemical sensitivities.
I agree to abide by the rules for CSDA meetings and phone conferences:
Meeting Rules:
1. No scented products will be worn or otherwise brought to meetings, including personal-care products or various laundry products. Anyone wearing a detectable fragrance may be asked to leave the meeting / event.
2. Cell phones and wireless devices will be turned off during meetings. (The only exception applies to doctors who are on call.)
3. Members are asked not to bring computers to the meetings. (The only exception is the use a computer as part of a speaker’s presentation.)
4. For meetings held in the library, participants will abide by the library rules for the use of the library’s conference room.
5. Anyone acting contrary to the express purposes of CSDA or the safety of its members or attendees may be asked to leave a CSDA event.
6. Participants will be courteous to all those attending the meeting and will remember to give everyone an equal chance to ask questions and make comments.
7. Anyone ignoring the directions / requests of the CSDA leadership may be asked to leave the meeting.
Rules for Phone in Conferencing:
The purposes of the conference calls are to provide social support and helpful information about Chemical Sensitivity, to educate others about Chemical Sensitivity, and to find ways to help people to cope with problems caused by Chemical Sensitivity. In keeping with CSDA’s role as a 501(c) 3 support group, CSDA does not endorse products or services that may be mentioned on these conference calls. Selling of products or services will not be permitted.
The Moderator of the conference call may make announcements concerning upcoming conference-call or meeting dates, scheduled speakers, and other events of interest to those with environmental illness.
Your phone company will charge you normal long-distance rates for your call-in unless you have an unlimited long-distance plan. If you have 3-way calling, you may enable someone with a limited plan to connect without charge.
As call participants, you are expected to adhere to the following procedures:
1. Announce yourself by stating your first name or nick-name. Only CSDA members are eligible to participate. If the Moderator cannot verify your identification, the Moderator has the right to disconnect you.
2. Speak slowly and clearly, do not interrupt, and allow everyone to participate. If the Moderator believes that you are monopolizing a discussion, he/she may ask you to draw your discussion to a close. If you do not comply, the Moderator may give you a warning, after which your phone may be muted.
3. Be courteous and positive throughout the calls. Disruptive or argumentative behavior is grounds for being muted or, if necessary, disconnected. If such behavior persists during subsequent calls, the Moderator, subject to confirmation by the Board, has the right to block your participation in future conference calls.
4. Have paper and pen for noting any shared information, e.g., phone numbers.
5. If you intend only to listen, either mute your own phone or utilize the call system’s mute feature by pressing *6. (Press *6 again to unmute.)
6. If you need to accept a “call waiting” call, be sure to hang up first and then reenter the conference call. (Otherwise, problems with background music can occur.)
7. By law, participants must be notified if their conversations are being taped. CSDA will not record these conference calls. The conference call service provides an automated warning to all callers should the system’s recording feature be inadvertently activated. Do not record these conference calls.
8. Decide in advance what measure of privacy or anonymity you wish to adopt. Do not discuss issues that might be private. Although CSDA believes that conference call lines are secure, it cannot guarantee total security at any given time.
Only CSDA members will be eligible to participate in CSDA sponsored telephone conferences. Nonmembers may attend CSDA meetings but are expected to abide by CSDA rules. Any advice given during CSDA meetings or conference calls is not to be construed as medical advice, if it is not given by a medical doctor.
I understand that my membership will remain in effect until I inform the CSDA in writing that I wish to rescind my membership or the CSDA Board of Directors, by majority vote, deems it necessary to rescind my membership and informs me of their decision in writing.
I am informed that anyone who acts contrary to the express purposes of CSDA or the safety of its members is liable to expulsion from CSDA. Likewise, anyone affiliated with an organization that is deemed by CSDA to be detrimental to CSDA or the safety of its members is liable to expulsion. CSDA retains the right to rescind membership without cause.
CSDA will keep this application on file. Applications will be used to compile a list of members. This information will be made available to CSDA President, Vice President, Secretary, Treasurer, and Telephone Conference Moderator as needed to conduct CSDA business. Board members may designate CSDA members to assist them in carrying out the functions of their office. While acting in this capacity, the designated assistants may have access to CSDA members’ contact information, including e-mail addresses and phone numbers. This list will not be sold or given to third parties and will not be made public.
My signature below signifies that I have read and agree to the above stipulations.
Signed:
Printed name:
Address:
Telephone number:
Email address:
Date: