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AHPBA 2027 Call for Leadership Volunteers

Please complete the information below to submit interest for a leadership role in the AHPBA.

1. Contact Information: *This question is required.

First Name

Last Name

Country

Email Address

2. AHPBA Member Type *This question is required.

3. Number of years in practice: *This question is required.

Please enter an 'other' value for this selection.

4. What is your practice setting? *This question is required.

Please enter an 'other' value for this selection.

5. Are you interested in being considered for any of the following open positions? If yes, please check all options that apply. *This question is required.

Officer (2 years previous service on Council required)
Member at Large or Junior Member at Large <=5yrs in practice (Elected by Membership in vote sent via email)
Committee Chair/Co-Chair (recommended to apply only if currently serving or previously served on the committee)
Committee Member (Indicate specific committee below)

Have you served at least 2 years on the AHPBA Executive Council, and are interested in being Treasurer?
The term is 2 years *This question is required.

Please indicate which committee you are interested in serving as Chair or Co-Chair.
Term is 2 years, and it is recommended candidates are currently serving on the committee, or have served on the committee. *This question is required.

Community, Wellness & Engagement Chair
International Relations Chair
Junior Surgeons Chair
Membership Chair
Surgical Innovation Chair

Please select your top 3 areas of interest: *This question is required.

Clinical Trials
Community, Wellness & Engagement
Education & Training
International Relations
Junior Surgeons
Membership
Advanced Practice Providers
Professional Standards
Program
Research
Surgical Innovation

6. Please enter a short bio *This question is required.

7. Please include a personal statement including past positions served for the AHPBA, and your areas of interest and expertise. *This question is required.