AMSA House of Delegates Reference Committee Application

Applications must be received by 11:59pm PST on February 14, 2022. If you have any questions, please contact the House of Delegates Chair at vpia@amsa.org.

I am applying for*

Reference Committee

Name*

Please enter first and last name.

Email Address*

Phone Number

School*

Stage of Training

Select or enter value

Anticipated Graduation Year*

Are you an AMSA Member?*

Note: All committee members must be AMSA members at the time of selection. If you are not currently a member, visit amsa.org/join to sign up.

Yes

Are you interested in serving as a Committee Chair?*

Yes

Have you or are you planning to submit any resolutions for consideration by the 2022 AMSA House of Delegates?*

Note: AMSA members who have or are planning to submit resolutions for consideration are not eligible to serve as a member of the Reference Committee.

Yes

Paragraph of Intent*

(no more than 100 words)

Resume/CV*

Please attach your resume/CV here.

Drag and drop files here or

Reference committee members are expected to participate in virtual training and other duties prior to Convention, as well as attend and participate in AMSA's Annual Convention.

I understand.*

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