Committee Interest Form

One of the most valuable ways a member can partner with Ohio ACEP is to participate on a committee. We welcome your participation. Ohio ACEP committees provide leadership on important issues, further the work of the strategic plan and assist with activities for the year and serve as a valuable resource to the Ohio ACEP Board of Directors and our Chapter.
Please complete the information below for the committee(s) that interest you. Committees meet at least once per year in person and then by conference call year round. Committee members will be appointed in January of each year. We do ask that if you join a committee, you commit to attendance and participation.
After completing this online application, please finalize your application by sending a CV within two weeks of submitting this form to Ohio ACEP Executive Director, Holly Dorr at hdorr@ohacep.org.

Contact Information

First Name
Last Name
Credentials
Address 1
Address 2
City
State
Zip
Phone
Email

Please select the committee you are interested in serving on:

Is there another committee you are interested in serving on?

 

Description

In 150 words or less, please provide your statement of interest.
   - denotes required fields