Request for Volunteer Recognition Letter

Request for Volunteer Recognition Letter
PCICS members who participate in Committees, Special Interest Groups (SIGs), or governing bodies of the Society may request a letter once annually to be sent to their institution's leadership acknowledging their hard work and volunteerism in PCICS.

The PCICS letter of recognition will be signed by the PCICS President and sent to the relevant individual at the members' institution within 8 - 12 weeks of receiving the completed form which follows.
Your Name*

First NameLast Name
Your Credentials*
Your Email*
Institution*
Name of Your Division Chief, Department Chair, or individual to which the letter should be sent*

First NameLast Name
Their Credentials*
Their Email*
Connections CommitteeDiversity, Equity & Inclusion CommitteeEducation CommitteeFinance CommitteeInternational CommitteeQuality Improvement & Safety CommitteeResearch CommitteeAdvanced Practice Provider (APP) SIGBedside Nursing SIGClinical Nurse Specialist/Educator SIGFellow/Early Career Physician SIGInterdisciplinary Leadership SIGNeuroCardiac SIGNutrition SIGOccupational Therapy/Physical Therapy/Speech Therapy/Child Life Specialist SIGPharmacy SIGExecutive CommitteeFoundation Board of TrusteesBoard of Directors
Briefly describe your PCICS volunteer activities in the past year.*
Please indicate the approximate number of hours you spent on your PCICS volunteer activities in the past year.*
Should be Empty: