Membership Application Name * First Name Last Name Email * Phone (###) ### #### What is your employment status? * Current federal employee Former federal employee Current full-time federal contractor Other Employer * If you are a full-time federal contractor, please put your contracting company in parentheses. Example: U.S. Department of Defense (Company X) Job Location * City and State Job Title / Position * Career Level * Please choose exact or equivalent level. GS-05/FS-09 (or below) GS-06/FS-08 GS-07/FS-07 GS-08/FS-06 GS-09/FS-05 GS-10/FS-05 GS-11/FS-04 GS-12/FS-03/FS-04 GS-13/FS-03 GS-14/FS-02 GS-15/FS-01 SES What committee(s) are you interested in joining? * Check all that apply. Social Events and Networking Mentorship Membership None at this time Are there other ways you are willing to volunteer? How did you hear about us? * Search engine (i.e. Google, Yahoo) Recommended by friend or colleague Social Media Mosaic Website Mosaic Event Mosaic Email Other Do you want to be added to our Signal group? * If yes, make sure to fill out your phone number at the top of the form. Yes No Thank you for your Mosaic Feds membership application. Please pay your dues to complete your membership. If you have any questions, please email contact@mosaicfeds.org.
