Thanks for participating in the Member Spotlight! For us to use your Spotlight, you must complete the Media Release following completion of this submission. Instructions below.

What is your SIIM Persona?(Required)

For the remaining questions, please keep your answers to 1-2 sentences only.

We can always use a standard headshot, but if you happen to have a more casual picture that might reflect more about you, we’ll take that instead!
Max. file size: 128 MB.

Media Release Requirement (complete after submitting this form)

  • Sign in to your My SIIM Account (username is your email address on file at SIIM)
  • In the left navigation, go to Edit My Profile
  • Scroll down to the Media Release section.