AUPN Call For Committee Volunteers (2019)

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* 1. Member Information

Name

Institution

Email Address

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* 2. Membership Type

Department Chair

Residency Program Director

Clerkship Director

Child Neurology Residency Program Director

Research Program Director

VA Director

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* 3. Please select the Committee(s) you wish to volunteer for:

Program Committee (Chairs Only)

Online Engagement Committee

AUPN Branding Task Force

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* 4. Please provide a brief a statement as to why you are interested in serving on your desired Committee(s)

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* 5. Please upload a CV for consideration

PDF, DOCX, DOC file types only.