ACPNJ 2019 Northern and Southern Regions - Council Nominations

ACPNJ North and South Council Elections

A call for nominations to serve as a Council member representing the Northern and Southern Regions is now open. Please consider nominating yourself or a colleague. Council members serve a 2-year term and attend 4 in-person Council meetings a year. If you are interested in running for the Council please complete the form below.

Question Title

* 1. Please provide the following information:

Name

Practice

Address

City/Town, State, Zip

Email Address

Phone Number

Question Title

* 2. Are you interested in running for a council seat from the northern or southern region?

Northern Region

Southern Region

ACPNJ 2019 Northern and Southern Regions - Council Nominations

ACPNJ North and South Council Elections

Question Title

* 1. Please provide the following information:

Question Title

* 2. Are you interested in running for a council seat from the northern or southern region?

Question Title

* 3. Please describe your practice (solo, group, hospital owned, residency, etc.):

Question Title

* 4. Please briefly tell us why you are interested in running for the Council.