ACOEM Ambassador Program Event Exit Survey
Thank you for hosting or participating in an event for the ACOEM Ambassador Program! Please fill out this brief form so the Ambassador Working Group can better tailor our efforts for future events. Questions? Please reach out to Marketing Coordinator Charlie Peckman at charlie@acoem.org.
Name
First Name
Last Name
Credentials
Email Address
example@example.com
Event Date
-
Month
-
Day
Year
Date
Event Type
Career/Residency Fair
Lunch and Learn Event
Online Presentation/Panel Discussion
Other
What went well during your event? What would you change?
Any suggestions for the Ambassador Program?
Did you take any photos? Upload them below!
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Please upload any receipts for reimbursement from the Ambassador Program. Please note: expense reimbursement is subject to ACOEM staff approval.
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Submit
Should be Empty: