2024-2025 Interest Group Advisory Committee Applications Please note the following: - Current Interest Group advisory committee members do not need to reapply in order to remain on the committee for their term.- This form needs to be completed in one sitting. Returning to the form to complete the information is not an option. - Applications to multiple IG advisory committees are permitted. Question Title * 1. Applicant Contact Information Full Name Degrees/Credentials Organization Title/Position City/Town State/Province Email Address Question Title * 2. Applicant Demographic Information Gender Pronouns Race Ethnicity Area of expertise Discipline Question Title * 3. I would like to serve on the _________ Interest Group advisory committee. (Choose one) Child Health Services Research Disability Research Global Health Health Economics Health Equity Health Information Technology Health Workforce Interdisciplinary Research Group on Nursing Issues (IRGNI) Learning Health Systems Long-Term Services and Support Mental Health and Substance Use Research Oral Health Public Health Systems Research Quality and Value State Health Research and Policy Surgical and Perioperative Care Translation and Communication Women and Gender Health Next