MCAAP Legislative Committee Co-chair Application

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* 1. Please provide the following contact information:

First and Last Name

Institution/Practice

Title

Email Address

AAP ID#*

*You must be a member of the chapter to serve as a voting member. If you are not a member, you may join the chapter here: https://mcaap.org/become-a-member/

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* 2. Please list current/past roles in the MCAAP/AAP (local, district or national) and describe any current/past leadership activities outside of MCAAP/AAP.

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* 3. Please describe your interest in becoming Legislative Committee Chair including any specific contributions you would like to make to the Chapter and any specific topical interests (300 word limit).

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* 4. Please describe experiences that you have with legislative advocacy for children and families.

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* 5. Narrative biosketch: Please provide a brief biography here and email us your CV at chaggerty@mcaap.org. We recommend utilizing the following outline to write your biosketch:

Your current work and position as well as other pediatrics/advocacy related work

Past work experience and training history

Do you have any particular child advocacy interests (e.g. mental health, obesity, oral health)?