Governor Application

For your application to be considered by the ACOFP Leadership Development Committee, the following items must be submitted by September 1:

• Current CV, bio & high-resolution headshot
• Two letters of support that demonstrates that the nominee has provided leadership at the affiliate or national level. These letters can be provided by an ACOFP Affliate Society, the Chair of an ACOFP committee, work group or taskforce on which the nominee has served; or from the Department of Family Medicine from a COM or hospital in which the nominee is employed.

• Answer the following 2 interview questions in an essay format (up to 500 words for each essay)
  
  Tell us about your unique qualifications and why you are applying for the Governor position.
  
  How will you support ACOFP’s mission and vision should you be elected as Governor? How will you hold yourself accountable to commit the time and effort necessary to be successful in this role?
  
  

• Answer any 2 of the following interview questions (in a Video Recorded Response)
  
  o   Explain how you encountered a problem either professionally or personally and how you proceeded to correct that problem?

  o   Tell us about a conflict you were in and how you resolved it?

  o  In what ways do you see the role of Governor being important to the ACOFP?

  o   Share an experience you have had learning or working toward improving DEI efforts in your workplace or community.

Application materials must be uploaded below or sent to:

Annie DeVries
Executive Assistant/Governance
American College of Osteopathic Family Physicians
8501 W. Higgins Road, Suite 400
Chicago, IL  60631
annied@acofp.org

By submitting this application, a CV, a letter of support and a letter of intent, I agree to abide by the criteria listed and set by the Board of Governors of the American College of Osteopathic Family Physicians.

I hereby grant ACOFP the perpetual, absolute and irrevocable right and permission to use, reproduce, edit, exhibit, project, display, copyright, publish and/or resell photographic pictures that I provided and to circulate the same in all forms and media (including, but not limited to: on the ACOFP website and in any publications, any advertising/promotion, videotapes, audio tapes, compact discs, computer files and photographs) for educational, trade, all forms of advertising/promotion or any lawful purpose. I waive all claims to compensation and damages.