Registration Form

Collaborative Residency Evaluator Committee (CREC)
New Evaluator Training
Hilton Chicago O'Hare Airport

 
Saturday, April 29. 2023
9-12:30PM          Returning Evaluator Training
9-3:30PM           New Evaluator Training
Lunch provided at both trainings.

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* 1. Your name:

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* 2. Your email address:

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* 3. Your program name:

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* 4. Program type (select all that apply)

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* 5. Your current role in the program

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* 6. Are you a current on-site evaluator?
(Please Note: On-site evaluators must attend one full training workshop in order to continue to serve as active evaluators.)

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* 7. If you're a trained evaluator, which roles are you approved for? (Select all that apply)

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* 8. If you are not a trained evaluator, are you interested in becoming one?
(Please Note: ABFAS/ABPM has to approve all evaluator applications, see more information here.)

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* 9. Are you participating in the evaluator training?
(You don't need to be trained or approved evaluator candidate to attend this portion of the training. Attending this potion will provide insight into the evaluation process.)

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* 10. Do you want a vegetarian meal? (Unfortunately, we are unable to provide vegan options.)

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