2025-26 Physician Leadership Interest Form

1
Full name:* This field is required.
First Name
Last Name
2
Email address:* This field is required.
example@example.com
3
Are you a current ArMA member?* This field is required.To hold a position in ArMA's leadership, you must be an ArMA member and satisfy certain criteria specific to the leadership role of interest.
Yes
No
4
Which of the following leadership opportunities are you interested in?* This field is required.Please note, this is not an application for a leadership position. Once ArMA's leadership nomination process opens, you will be sent more information about applying to become a volunteer leader.
ArMA's Board of Directors
ArMPAC's Board of Directors
Standing committees (public health, membership, education, etc.)
ArMA's Private Practice Physicians Section Governing Council
ArMA's Medical Student Section Governing Council
ArMA's Resident & Fellow Governing Council
ArMA Foundation leadership
I am interested in serving as a mentor to a physician in training or early career physician.
Other
5
Have questions? Let us know, and we'll get back to you!
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