AMSA House of Delegates Nominations & Credentials Committee Application

I am applying for*

Credentials Committee Only

Nominations Committee Only

Credentials Committee (1st choice)-Nominations Committee (2nd choice)

Nominations Committee (1st choice)-Credentials Committee (2nd choice)

First Name*

Last Name*

Email Address*

Phone Number*

Phone

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

No

Are you interested in serving as a Committee Chair?*

Yes

No

Are you running for national office?*

Note: Candidates for national office are not eligible to serve on the Nominations or Credentials Committees.

Yes

No

Paragraph of Intent*

(no more than 100 words)

Resume/CV*

Please attach your resume/CV here.

Drag and drop files here or

Nominations and credentials 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*

Send me a copy of my responses