The Family Medicine PAC Board is seeking volunteer leaders to guide its work of providing family physicians in Michigan a strong voice in the state Legislature and helping MAFP to impact both health policy and the overall practice environment for family physicians. 

The Family Medicine PAC provides an opportunity to the members of MAFP to collectively support candidates for public office in Michigan who are interested in, and supportive of, issues that serve to uphold the mission of the MAFP.

The Family Medicine PAC values diverse leadership as its board is strengthened by differences in race, gender, ethnicity, age, sexual orientation, religion, practice areas and settings (solo, group practice, employed, academic, urban, rural, etc.), geographical regions, and philosophies about the family medicine specialty.

FMPAC Board member requirements and responsibilities are listed below:

· Be an active member of MAFP who is in good standing

· Support the mission of MAFP, which is to support family physicians in Michigan through leadership, collaboration, and innovation to achieve the best patient outcomes

· Be willing to commit the necessary time to serve on the FMPAC

· Build awareness of MAFP among legislators

· When possible, represent MAFP and its members at various events and programs

· Develop an understanding of MAFP’s governing process and the issues impacting family medicine, family physicians and their patients

· Attend the Michigan Family Medicine Conference & Expo and Annual Meeting of Members (held in the summer) to provide input on deliberations involving Academy governance.

To be considered to serve on the FMPAC Board, submit this completed application and an up-to-date copy of your curriculum vitae no later than March 1. To submit your CV, email it to; fax it to 517.347.1289; or mail it to MAFP, Attn: FMPAC Nominations, 2164 Commons Parkway, Okemos, MI 48864.

By submitting this application/nomination form, you are attesting that, if selected, you can fulfill the requirements and responsibilities listed above.

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* 1. This nomination is a:

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* 2. If this is a nomination by a colleague, does the nominee know that he/she has been nominated?

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* 3. Nominee's Contact Information

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* 4. Nominator's Contact Information (if this is a nomination by a colleague)

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* 5. Why are you interested in volunteering to serve on the FMPAC Board?

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* 6. If you were chosen to serve on the FMPAC Board, what would your expectations be?

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* 7. Do you have any prior expierence with a PAC or fundraising?

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* 8. Are you willing to finiancailly contribute to the FMPAC?