EOI - Victoria Annual Conference Working Group 2025

EOI - Victoria Annual Conference Working Group 2025
The 2025 Victoria Annual Conference will take place in mid-September in regional Victoria. The working group is open to FACEMs and ACEM trainees from across Victoria.

Following a fantastic event in Healesville in 2023, and another in Creswick in 2024, the conference will move to a new regional location of Victoria annually. The conference is held across three days from Friday to Sunday.

If you and your colleagues would like to be considered to host the conference in your area of Victoria, submit the form below.

Closing date: 5pm AEST, Wednesday 23 October.
Name
Please enter your first and last name.
ACEM ID*
Please enter your ACEM membership number.
Mobile phone number*
Please enter a valid phone number.
Email*
example@example.com
ACEM Membership Category*

FACEMTraineeOther
Which city do you work in?*
Which hospital will you be representing?*
Location in Victoria you would like to put forward for hosting the 2025 conference:*
Working Group Support
Please indicate if there are additional people who would like to be involved in or support your expression of interest to be part of the working group.
Attendance

2018 ASM, Perth, Australia2019 VIC Conference2019 ASM, Hobart, Australia2020 Virtual ASM2022 Spring Symposium, Christchurch, Aotearoa New Zealand20223 Winter Symposium, Newcastle, Australia2023 VIC Conference2024 Aotearoa New Zealand Conference2024 Queensland Symposium2024 Regional, Rural and Remote Conference, Darwin, Australia2024 VIC Conference (13-15 September 2024)
Areas of interest

Developing the programOrganising social functionsOrganising workshops
Would you like to be considered for the role of Chair of this working group?*

Yes, I'd like to be considered for ChairNo, I would not like to be considered for Chair
The VIC Conference Working Group Chair is identified as a senior FACEM who is responsible for chairing meetings alongside the ACEM Event Coordinator, and to assist the working group by referencing any relevant guidelines or policies that may need to be adhered to when delivering outcomes or recommendations.
Statement of Suitability*

Please include a short statement of suitability/intent indicating knowledge, skills and experience relevant to the Working Group for which you are applying.0/500
ACEM Core Values Module

The ACEM Core Values of respect, integrity, collaboration, and equity define the organisations guiding principles, and underpin the way ACEM works in order to meet its vision and mission of ensuring the highest standards are maintained in the training of emergency physicians, and in the provision of emergency care to the communities of Australia and Aotearoa New Zealand. From the start of 2022, all future appointees to ACEM roles and entities are required to have completed the ACEM Core Values Module; the close of the applicable expression of interest/nomination process and outline how they demonstrate the Core Values within their workplace.
Have you completed the ACEM Core Values Module?*

YesNo
Demonstrate Core Values*
Please describe how you demonstrate all four ACEM Core Values within your workplace. In respect to retired Fellows please describe how you demonstrate the ACEM Core Values in your dealings with others.
Conflicts of Interest
Please identify any actual or perceived conflicts of interest.
I acknowledge that the information that I have provided on this form will be provided to ACEM staff.*

I acknowledge
Should be Empty: