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* 1. Please provide your name and contact information.

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* 2. What is your current position?

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* 3. How would you describe your current position(s)? Select all that apply.

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* 4. Why do you want to serve on the MN-ACP Council and what qualities would you bring to the Council if elected?  (200 words max)

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* 5. What would be your areas of interest in working on the Council? (200 words max)

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* 6. Which position on the Council are you interested in....Treasurer or Greater Minnesota Internist representative? 

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* 7. Please submit an electronic copy of your CV to Minnesota.ACP@gmail.com for the Nominations Committee consideration by May 15, 2020. A slate of candidates will be selected by June 1, 2020 and all candidates will be notified. If you have additional questions, please email Minnesota.ACP@gmail.com

Do you have any additional information you would like added to this nomination (200 word max)?

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