1. Default Section

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* 1. Please provide us with your name:

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* 2. What is your career status?

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* 3. Are you interested in volunteer opportunities organized by the NCMS, especially for Senior Physicians? (Please select all that apply)

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* 4. Please provide your preferred email address for contacting you about potential Senior Physician activities.

THANK YOU for your time and interest in the NC Medical Society!

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