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ACLP Volunteer for Membership Cmte 2024

Thanks for your interest in the Membership Committee. If you are appointed to this committee, your term of service starts on Nov. 1, 2024, and not any sooner.

1. Your contact details *This question is required.

First name
Last name
Credentials (MD, etc.)
Email

2. What is your current career stage? *This question is required.

3. Please indicate on which subcommittee(s) you would like to serve. You can select more than one. *This question is required.

Membership Committee
Fellowship & Awards Subcommittee
Business of CLP Subcommittee
Mentorship Subcommittee
Diversity, Equity & Inclusion Subcommittee

Describe your interest in serving on the Membership Committee (i.e., why are you applying?). Include in your comments any experience and/or skills you possess relevant to service, including prior history with the committee. *This question is required.

Describe your interest in serving on the Fellowship & Awards Subcommittee (i.e., why are you applying?). Include in your comments any experience and/or skills you possess relevant to service, including prior history with the committee. *This question is required.

Describe your interest in serving on the Business of CLP Subcommittee (i.e., why are you applying?). Include in your comments any experience and/or skills you possess relevant to service, including prior history with the committee. *This question is required.

Describe your interest in serving on the Mentorship Subcommittee (i.e., why are you applying?). Include in your comments any experience and/or skills you possess relevant to service, including prior history with the committee. *This question is required.

Describe your interest in serving on the Diversity, Equity & Inclusion Subcommittee (i.e., why are you applying?). Include in your comments any experience and/or skills you possess relevant to service, including prior history with the committee. *This question is required.