1.I wish to cast my vote IN FAVOR of Lauren Osborne MD for President Elect

YES

NO

2.I wish to cast my vote IN FAVOR of Mary Kimmel MD for Treasurer Elect (as listed below)

Yes 

NO

3.I wish to cast my vote IN FAVOR of Jaime Belsito for Community Member Liasion

Yes

No

4.I wish to cast my vote for the following (3) Board of Directors for MONA. (please make (3) selections)

Amritha Bhat, MD, MPH

Harita Raja MD

Kristina M. Deligiannidis, MD

Lucy Barker, MD PhD FRCPC

Lindsay R. Standeven, M.D.

Tracy Moran Vozar, Ph.D., IMH-E (IV-R)

5.Please confirm name and email to verify membership status.   This information will be confidential and will be used for member verification purposes only.  

Please enter first and last name

Please enter email