2023 Leadership Candidate Self Assessment SECTION 1- CANDIDATE INFORMATION Question Title * Name: Question Title * Best daytime contact (phone and email) Question Title * Date of Birth Question Title * Institution/Company Name Question Title * Primary Area of Practice: Academic Medicine (list subspecialty) Private Practice Subspecialty Question Title * Please select the area for which you are being nominated. ASE Vice President ASE Board of Director- Member at Large ASE Leadership Academy Candidate ASE International Member ASEF Member at Large - Global Medical Outreach ASEF Member at Large - Fundraising ASEF Professional Fundraiser ASE Council Steering Committee Position If you are applying for a Council Steering Committee, please state which one(s). Next