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2026 Application for Ohio Resident Delegate to the AAFP National Congress of Family Medicine Residents at FUTURE

Complete the following application for resident delegate by Monday, June 15, 2026. If you have questions about the application or role, contact Caitlin Laudeman at claudeman@ohioafp.org.

A full description of the role and application requirements can be found on the OAFP website.
1.First Name:(Required.)
2.Last Name: (Required.)
3.Designation
4.Email:(Required.)
5.Phone:(Required.)
6.Residency Program:(Required.)
7.Year in residency as of July 30, 2026:(Required.)
8.Candidates for resident delegate must have participated in at least one OAFP/OAFP Foundation activity during residency. Please list OAFP activities in which you have participated - events, leadership roles, committee membership, etc.:(Required.)
9.Have you previously attended FUTURE, formerly the National Conference of Family Medicine Residents and Medical Students?(Required.)
10.Have you previously served as a delegate/alternate delegate to the National Congress of Family Medicine Residents or National Congress of Student Members?(Required.)
11.Are you interested in running for an elected national leadership position with AAFP?(Required.)
12.Will you be receiving additional funding to attend FUTURE? (This includes scholarships and/or monetary support from the AAFP, OAFP, your residency, etc. Additional funding received by the selected delegate/alternate should be disclosed to the OAFP Foundation and will be deducted from the reimbursement amount available.)(Required.)