ASCP Committee Application

Institution/Employer Information
Institution/Employer Name*
Your Role*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Volunteer History
Please list your previous ASCP volunteer committee positions, if applicable:
Please indicate if you are, or have been, involved in any of the following ASCP programs:

ASCP 40 Under Forty RecipientASCP Ambassador ProgramASCP Award RecipientASCP Education Faculty SpeakerASCP Local ChapterASCP Mentorship Program (Mentor)ASCP Mentorship Program (Mentee)ASCP Poster PresenterASCP Scholarship Recipient
Please indicate which year you received your 40 Under Forty Recipient status:
Please indicate which ASCP award(s) you have received:
Please indicate which live learning sessions you were a faculty speaker at:
examples: AM (use for Annual Meeting) 2025, KL (us for KnowledgeLab) 2025, PU (use for PathUpdate) 2025, etc.
Please indicate which ASCP Local Chapter you are a part of:
Please indicate which year you presented your poster at an ASCP Annual Meeting:
Please indicate which ASCP scholarship(s) you have recieved:
Please list any other relevant external volunteer positions (past/current), if applicable:

Personal Statement Questions
How do you see yourself advancing ASCP's mission through the committee(s) you applied for? What strengths do you bring as a member volunteer? *

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How has your personal or professional journey influenced the way you collaborate with people from varied backgrounds? What ideas do you have for making our work accessible and meaningful across the many different roles and practice settings in pathology/laboratory medicine? *

0/300
Describe your ability to lead a task-oriented workgroup.

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What is your vision for the future of the laboratory workforce?

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How do you think ASCP's social media strategy can increase the visibility of pathology and laboratory medicine?

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What would you like for patients to know more about regarding laboratory medicine and pathology?

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To maintain the confidentiality and integrity of ASCP BOC examination content, members of the Exam Readiness Committee must observe a minimum one-year waiting period before becoming eligible to contribute to any ASCP examination readiness resources. Please provide the approximate dates of service for all past or current volunteer roles with the ASCP BOC in any capacity.

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Professional Referral

Please share the contact information for a past/current ASCP volunteer that can attest to your ability to serve as an ASCP volunteer. This reference is optional.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Relationship*
Final Steps
List here any potential conflicts of interest that may interact with your contributions to the ASCP volunteer program:*
If there are none, please submit "N/A".
For more information regarding what ASCP constitutes as a conflict of interest, please click here.
Upload your Curriculum Vitae (CV) or resume here:*

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To the best of my knowledge, the information provided in this application is accurate. *

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ASCP Committee Volunteer Application