2023-2024 ADIEM Committee Interest Form Question Title * 1. Full Name Question Title * 2. Institution Name Question Title * 3. Professional/Institution Email Address Question Title * 4. Personal Email Address (This is used for accuracy/tracking in the SAEM database) Question Title * 5. Please select up to 3 committees you would like to join, with 1 being your top choice and 3 your last choice. 1 2 3 N/A Social Media Committee Social Media Committee 1 Social Media Committee 2 Social Media Committee 3 Social Media Committee N/A Education Committee Education Committee 1 Education Committee 2 Education Committee 3 Education Committee N/A Accommodations Committee Accommodations Committee 1 Accommodations Committee 2 Accommodations Committee 3 Accommodations Committee N/A Membership Committee Membership Committee 1 Membership Committee 2 Membership Committee 3 Membership Committee N/A Nominating Committee Nominating Committee 1 Nominating Committee 2 Nominating Committee 3 Nominating Committee N/A Research Committee Research Committee 1 Research Committee 2 Research Committee 3 Research Committee N/A LGBTQIA+ Committee LGBTQIA+ Committee 1 LGBTQIA+ Committee 2 LGBTQIA+ Committee 3 LGBTQIA+ Committee N/A Mentorship/Student and Trainee Committee Mentorship/Student and Trainee Committee 1 Mentorship/Student and Trainee Committee 2 Mentorship/Student and Trainee Committee 3 Mentorship/Student and Trainee Committee N/A Operations Committee Operations Committee 1 Operations Committee 2 Operations Committee 3 Operations Committee N/A Thank you for completing the 2023-2024 ADIEM Committee Interest Form. Please click on done to submit your selections. Done