2021-2022 AACEM Workgroup/Committee Sign-Up Form Question Title * Full Name (include middle initial, if applicable) Question Title * Institution Name Question Title * Professional/Institution Email Address Question Title * Please select up to 3 committees you would like to join, with 1 being your top choice and 3 your last choice. If you have questions about a particular committee, please review the AACEM workgroup and committee descriptions. 1 2 3 Boarding Workgroup Boarding Workgroup 1 Boarding Workgroup 2 Boarding Workgroup 3 Community Workgroup Community Workgroup 1 Community Workgroup 2 Community Workgroup 3 Diversity, Equity, and Inclusion (DEI) Workgroup Diversity, Equity, and Inclusion (DEI) Workgroup 1 Diversity, Equity, and Inclusion (DEI) Workgroup 2 Diversity, Equity, and Inclusion (DEI) Workgroup 3 Leader Development Workgroup Leader Development Workgroup 1 Leader Development Workgroup 2 Leader Development Workgroup 3 Member Advocacy Workgroup Member Advocacy Workgroup 1 Member Advocacy Workgroup 2 Member Advocacy Workgroup 3 Membership Committee Membership Committee 1 Membership Committee 2 Membership Committee 3 Research Workgroup Research Workgroup 1 Research Workgroup 2 Research Workgroup 3 Question Title * If you would like to be considered to be an AACEM workgroup or committee chair, please select which AACEM workgroup or committee. Boarding Workgroup Community Workgroup Leader Development Workgroup Member Advocacy Workgroup Membership Committee Question Title * Do you plan on attending ACEP's 2021 Scientific Assembly from October 25 - 28, 2021 in Boston, MA? Yes No Unsure Thank you for completing the 2021-2022 AACEM Workgroup and Committee Form. Notifications for workgroup and committee appointments will go out the beginning of May 2021.Please click "Submit" to finalize your selections. With support and leadership from the AACEM Executive Committee, workgroups and committee members play a role in influencing the direction of AACEM and charting the course for the future of academic emergency medicine. The 2021-2022 term of service for workgroups and committees will begin in May 2021 and end at SAEM's Annual Meeting in May 2022. We invite you to review the workgroup and committee descriptions and select which ones are of greatest interest to you. Please note that we will make every effort to assign you your primary choice, but due to the popularity of some workgroups and committees, we cannot provide a guarantee. Notification of workgroup and committee selections will be sent out in the last week of June. Sign-up by Friday, April 9, 2021! Page1 / 1 100% of survey complete. Submit
