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* 1. Please provide your contact information.

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* 2. Please enter the name and contact information of the person you are nominating to serve as the Resident Trainee on the ASCCP Board of Directors. (Note: All nominees must be current ASCCP members)

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* 3. Please upload a copy of the nominee's CV/Resume.

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* 4. Please provide a brief explanation of why you think this nominee should be considered for the Resident Trainee position on the ASCCP Board of Directors:

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