ACOEM Ambassador Program Interest Form
Thank you for taking time to fill out the Ambassador Program interest form! By joining this group of dynamic OEM professionals, you can help shape the next generation of occupational and environmental medicine thought leaders.
Name
First Name
Last Name
Credentials
Email
example@example.com
Which element(s) of the Ambassador Program interest you?
Hosting an event – standing at an OEM-specific table during a residency/career fair, hosting a lunch and learn, or presenting the Ambassador Program presentation
School outreach – getting in touch with your alma mater to find out about upcoming career fairs and other educational events
Coordination – facilitating communication between the ACOEM Ambassador Program and universities or medical schools
Other
Do you have any additional comments or suggestions?
Submit
Should be Empty: