Student and Resident Board Member Application (deadline 12/1)
IA IL IN KS MI MN MO NE ND SD WI
About the role
One student and one resident will serve a one-year term for the calendar year 2025. Board members are expected to attend a one-hour zoom meeting every other month and also attend the entire 2025 conference in Naperville (Chicagoland) Illinois September 11-13, including any board meetings held before or immediately following the conference. Board members may be asked to serve on task forces to work in specific assignments for the FMM Board to further the mission and promote the conference. All applications are reviewed by the current FMM student and resident board members and the board chair. A decision will be made at the FMM Board December meeting. AAFP Membership is required.
Student Criteria to serve on the board
Currently enrolled as M1, M2 or M3 in an allopathic or osteopathic medical school in the FMM twelve-state region and attended a previous FMM conference. Preference will be given to applicants who have presented at a previous FMM conference (poster or session) or have served on the Conference Host or Education Planning Committee and plan to apply to family medicine residency.
Resident Criteria to serve on the board
Family medicine residents currently enrolled as PGY-1 or PGY-2 in a family medicine residency program in the FMM twelve-state region. Attended a previous FMM conference as a resident or as a student. Preference will be given to nominees who have served on the Conference Host or Education Program Committee, or have presented at a previous FMM conference (poster or session) as a resident or medical student.
Name
First Name
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Last Name
*
I am a
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Medical student
Resident
Medical School
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Residency Program (if applying for resident board member)
Expected Graduation Year
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AAFP member number
*
What year(s) did you attend Family Medicine Midwest?
Check if you have served on these FMM committees
Host Committee
Education Program Committee
Have you presented at FMM? Check all that apply
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Presented a Poster
Presented a session
Will submit an abstract in 2025
None of the above
Mailing Address
Street Address
Address Line 2
City
State
*
Please Select
AL
AK
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AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
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OR
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VA
WA
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Postal Code / Zip Code
E-Mail
*
Phone Number
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Please provide a maximum of 250 words explaining why you would like to join the board.
*
Are you a member of the AAFP?
*
Yes
No
Provide the name and email address of a family medicine faculty member to serve as a reference for you
*
Please upload your CV here
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