Clone of 2025-2026 AAPM Resident Ambassadors Application

AAPM Resident Ambassadors Application

Preference will be given to residents in PGY-1 through PGY-3 training years. Current and former AAPM Resident Ambassadors are welcome and encouraged to reapply. Previous participation will be considered during the review process. Applications open till June 26, 2026.
First Name
Last Name
Professional Credentials
ex. MD, DO, MBBS
Email Address
Are you currently an AAPM member?
Specialty

Other
Program
Please enter your program here if it isn't listed above
City
State (ex. NY, MD, CA)
What is your current level of training?
Referred By:
First and Last Name
Would you like to be considered for a Resident Ambassador leadership role?
Which leadership role(s) interest you?
Feel free to list any leadership positions you have held.
Brief Statement of Interest

Why are you interested in serving as an AAPM Resident Ambassador? How do you hope to contribute to the program?0/150
Specific Interests:
CV

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Headshot

You can email it to amoyaclark@painmed.org at another time if needed.
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Resident Ambassador Expectations

By submitting this application, I understand and agree to actively participate in the AAPM Resident Ambassador Program. This includes attending quarterly ambassador meetings, serving as an AAPM representative within my residency program, sharing relevant AAPM opportunities and initiatives with peers, and participating in at least one ambassador activity or initiative during my term.
Should be Empty:

AAPM Resident Ambassadors Application