2019 Ohio ACEP Board of Directors Application

NOMINATION DEADLINE – January 30, 2019
Thank you for your interest in serving the Chapter in a leadership role. Physician leadership is important to our Chapter and we value your interest in volunteering your time and talents in this capacity. Board members serve a 3-year term.
Today’s Date
Full Name with Credentials
Hospital
Physician Group
Cell Phone
Email
I wish to run for election to the Ohio ACEP Board of Directors.
Initial here:
If elected, I agree to serve as a 3-year term as an Ohio ACEP Chapter Board member beginning at the Annual Meeting 2019 until the Annual Meeting 2022. I have read and agree to the Ohio ACEP Board Member Commitment Statement.
Initial here:
CLICK HERE to View Board Member Commitment Statement
In support of my nomination, and in order to publicize my candidacy, I will submit the following by January 30, 2019:
-a candidate statement [Please keep statements under 270 words]
-a CV, and
-a headshot photo
to Laura Tiberi, Executive Director at ltiberi@ohacep.org
Initial here:
Thank you. Ohio ACEP Board of Directors elections will be held March 20, 2019 at the Ohio ACEP EM Assembly in Columbus, Ohio.