2023 Community Co-Chair Nominations

Please use the following form to submit a nomination for Community co-chair.

Note: This system does not allow you to save and return to your work. Please make sure you have all nomination items and documents ready prior to accessing and completing this form.

Please email practice@aanp.org with any questions.

Nominations close Wednesday, April 19th, 2023.

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* 1. First Name:

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* 2. Last Name:

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* 3. Email Address:

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* 4. Community Position of Interest:

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* 5. Personal Statement:
Identify interest and what you would offer the role

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* 6. Upload current CV:

PDF, DOCX, DOC file types only.

Choose File

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* 7. Upload Professional Reference - Professional

PDF, DOCX, DOC file types only.

Choose File

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* 8. Upload Professional Reference - Leadership Capability

PDF, DOCX, DOC file types only.

Choose File

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* 9. I attest that I have read the SPG guidelines and agree to adhere to those guidelines to ensure support of AANP's goals and mission.

Yes, I attest

No, I do not attest

2023 Community Co-Chair Nominations

Question Title

* 1. First Name:

Question Title

* 2. Last Name:

Question Title

* 3. Email Address:

Question Title

* 4. Community Position of Interest:

Question Title

* 5. Personal Statement:Identify interest and what you would offer the role

Question Title

* 6. Upload current CV:

Question Title

* 7. Upload Professional Reference - Professional

Question Title

* 8. Upload Professional Reference - Leadership Capability

Question Title

* 9. I attest that I have read the SPG guidelines and agree to adhere to those guidelines to ensure support of AANP's goals and mission.

* 5. Personal Statement:
Identify interest and what you would offer the role