2018-2019 CDEM Committee Interest Form

Submission are due by Friday, July 6, 2018

As a committee member of CDEM, you will play an important role in influencing the direction of CDEM at large and charting the course for the future. Operating under the leadership of the CDEM Executive Committee and with full support from the entire SAEM leadership, you will help develop future educational solutions that address the needs and wishes of undergraduate medical educators and our students. The 2018-2019 term of service for committees will begin at the end of July 2018 and end at SAEM's Annual Meeting in May 2019.

We invite you to review the CDEM committee descriptions and select which ones are of greatest interest to you. Please note that we will make every effort to assign you your primary choice, but due to the popularity of some committees, we cannot provide a guarantee. Notification of committee selections will be sent out at the end of July 2018.

Submission are due by Friday, July 6, 2018.

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* 1. Full Name (include middle initial, if applicable):

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* 2. Institution Name

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* 3. What is your educational role?

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* 4. Professional/Institution Email Address:

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* 5. Personal Email Address (This is used for accuracy/tracking in the SAEM database):

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* 6. Please select up to 2 committees you would like to join, with 1 being your top choice and 2 your second choice. If you have questions about a particular committee, please review the committee descriptions.

	1	2
Curriculum and Assessment Committee	Curriculum and Assessment Committee 1	Curriculum and Assessment Committee 2
Membership and Engagement Committee	Membership and Engagement Committee 1	Membership and Engagement Committee 2
Career Development and Mentorship Committee	Career Development and Mentorship Committee 1	Career Development and Mentorship Committee 2
CDEM Planning Committee for SAEM	CDEM Planning Committee for SAEM 1	CDEM Planning Committee for SAEM 2
Communications and Social Media Committee	Communications and Social Media Committee 1	Communications and Social Media Committee 2
Awards Committee	Awards Committee 1	Awards Committee 2
Grants Committee	Grants Committee 1	Grants Committee 2
Research and Scholarship Committee	Research and Scholarship Committee 1	Research and Scholarship Committee 2
VSAS Taskforce	VSAS Taskforce 1	VSAS Taskforce 2

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* 7. Brief Statement of Interest: (optional)

Thank you for completing the 2018-2019 CDEM Committee Interest Form. Notifications for committee appointments will go out at the end of July 2018.

Please click on done to submit your selections.