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2025 AAPM&R Resident Retreat Application

Please complete the following application to be considered for AAPM&R's resident retreat taking place May 17 - 18, 2025 and May 31 - June 1, 2025. The deadline to complete this application is January 15th, 2025.
8. Is the above address your preferred mailing address? *This question is required.
9. Gender (Optional):
10. Do you consider yourself to be a gender or sexual minority (Optional)?
11. Which of the following may best describe yourself.  Check all that apply (Optional):
12. Do you consider yourself to have a disability as defined by the Americans with Disabilities Act (Optional)?
13. Are you currently in your second year of PM&R residency? *This question is required.
14. Which course(s) are you applying to attend? (Note: We may not be able to accommodate changes at a later time) (Check one): *This question is required.
18. Do you have any interest and/or experience in volunteering for a professional organization such as AAPM&R?    *This question is required.
Please attest to the following statements by checking each box:
 
24. Electronic Signature:
  *This question is required.
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Signature of
This question requires a valid date format of MM/DD/YYYY.
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26. Attach CV (Allowable File Types: png, jpg, jpeg, doc, docx, pdf): 
  *This question is required.
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