AAPCA1 Board 2022-23 Nomination Application - Santa Clara & South Valley

Thank you for your interest in a leadership role on the AAP California Chapter 1 board. Please complete the nomination application below to be considered for an open position.

Question Title

* 1. Please provide the following contact information:

Name (first, last)

Institution/Practice

Title

Email Address

AAP ID# *

*You must be a member of the chapter to serve on the board. If you are not a member, you may join the chapter here: https://aapca1.org/membership/

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* 2. I am applying for:
You may view our geographic breakdown here: https://aapca1.org/about/

MAL for Region 4 - South Valley

MAL for Region 6 - Santa Clara

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* 3. Please list current/past roles in the AAP (local, district or national).

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* 4. Please describe current/past leadership activities.

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* 5. Please describe experiences that you have with fostering diversity, equity and inclusion in a professional setting.

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* 6. Please describe your interest in the selected leadership position, including any specific contributions you would like to make to the Chapter and any specific topical interests (300 word limit).

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* 7. Narrative biosketch: Please provide a brief biography for the Nominating Committee to consider (250 word limit) and email us a CV at info@aapca1.org.

If you have any questions about the position or application, please do not hesitate to contact us at info@aapca1.org.

AAPCA1 Board 2022-23 Nomination Application - Santa Clara & South Valley

Question Title

* 1. Please provide the following contact information:

Question Title

* 2. I am applying for:You may view our geographic breakdown here: https://aapca1.org/about/

Question Title

* 3. Please list current/past roles in the AAP (local, district or national).

Question Title

* 4. Please describe current/past leadership activities.

Question Title

* 5. Please describe experiences that you have with fostering diversity, equity and inclusion in a professional setting.

Question Title

* 6. Please describe your interest in the selected leadership position, including any specific contributions you would like to make to the Chapter and any specific topical interests (300 word limit).

Question Title

* 7. Narrative biosketch: Please provide a brief biography for the Nominating Committee to consider (250 word limit) and email us a CV at info@aapca1.org.

* 2. I am applying for:
You may view our geographic breakdown here: https://aapca1.org/about/