2019 Ohio ACEP Councillor Candidate Application

NOMINATION DEADLINE – February 27, 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. Chapter Councillors serve a 2-year term.
Today’s Date
Full Name with Credentials
Hospital
Physician Group
Cell Phone
Email
I wish to run for Ohio ACEP Chapter Councillor.
Initial here:
If elected, I agree to serve a 2-year term as an Ohio ACEP Chapter Councillor beginning at the Annual Meeting 2019 until the Annual Meeting 2021. I have read and agree to the Ohio ACEP Councillor Commitment Statement.
Initial here:
CLICK HERE to view Councillor Commitment Statement
In support of my nomination, and in order to publicize my candidacy, I will submit the following by February 27, 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. Elections for Ohio ACEP Chapter Councillors will be held March 20, 2019 at the Ohio ACEP EM Assembly in Columbus, Ohio.