2021-2022 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. If you have questions about a particular committee, please review the committee descriptions. 1 2 3 Accommodations Committee Accommodations Committee 1 Accommodations Committee 2 Accommodations Committee 3 Awards Committee Awards Committee 1 Awards Committee 2 Awards Committee 3 Education Committee Education Committee 1 Education Committee 2 Education Committee 3 LGBTQ+ Committee LGBTQ+ Committee 1 LGBTQ+ Committee 2 LGBTQ+ Committee 3 Nominating Committee Nominating Committee 1 Nominating Committee 2 Nominating Committee 3 Research Committee Research Committee 1 Research Committee 2 Research Committee 3 Resident and Student Committee Resident and Student Committee 1 Resident and Student Committee 2 Resident and Student Committee 3 Social Media and Publications Committee Social Media and Publications Committee 1 Social Media and Publications Committee 2 Social Media and Publications Committee 3 Thank you for completing the 2021-2022 ADIEM Committee Interest Form. Please click on done to submit your selections. Done