2025 ArMA Elected Leaders Applicant Submission Form

ArMA 2025 Leadership Opportunities Applicant Submission Form
Thank you for your interest in serving in an ArMA leadership position.

This form is for the following:
- Medical Student Section Governing Council - Will serve a 1-Year term
- Residents & Fellow Section Governing Council - Will serve a 1-Year term
- Private Practice Physicians Section Governing Council - Will serve a 2-Year term
Please complete the information below and submit it by Friday, April 4, 2025.

If you have questions, please contact Susan Brown at sbrown@AZmed.org.

Interested in nominating a colleague for an ArMA leadership position? The link for the nomination form can be found here.

Interested in applying to serve on one of the ArMA Committees? The link for the application can be found here.
Nominee Name*

First NameLast Name
Work Organization / Practice Name*
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Cell Number*

Area CodePhone Number
Which entity are you applying for? (select only 1, if interested in applying for more than 1, please submit multiple applications)*

ArMA Medical Student Section LeadershipArMA Residents & Fellows Section LeadershipArMA Private Practice Physician Section Leadership
Select the county in which you work.*

ArMA 2025 Leadership Opportunities Applicant Submission Form