1	What is your primary interest in becoming involved with the Society for Mucosal Immunology (SMI)? I would like to nominate myself to stand for election to the SMI Board of Councilors. I would like to participate on one of SMI's committees. I am interested in becoming involved in the planning of the International Congress of Mucosal Immunology. I have a general interest in becoming involved with SMI. Other

2	Please enter your contact information so that SMI may contact you (if you are an SMI member, please just enter your name): Name Company Address 1 Address 2 City/Town State/Province Zip/Postal Code Country Email Address