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Committee Service Application

The AACVPR invites you to become more involved with the organization through service on one or more committees.  Please complete the application below for committee membership consideration.  Current AACVPR membership is the only requirement.  AACVPR has 11 committees from which to select your area of interest. Committee members serve a 3 year term starting from the annual meeting in the fall and renewable for one additional 3 year term.  An AACVPR representative will contact you regarding the status of your application prior to the annual meeting.  Applications for committee membership are to be submitted between May 1st and June 30th, and will be kept on file for one year.

**You must be a current member of AACVPR to be considered for committee membership.

**Students are encouraged to apply and serve a 1 year term, which can be renewed. Please email the national office immediately following the submission of your application.

Please note, applications and resumés/curriculum vitaes will be kept on file for ONE year after the date of receipt.

First
Last
Degree
Current Job Title
Work Affiliation

Professional Interest Area:
      Cardiac
      Pulmonary
      Cardiopulmonary
Address 1
Address 2
Address 3
City
State
Zip
Country
Email
Daytime Phone
Fax
Are you a current AACVPR member?
      Yes
      No
Are you an AACVPR Fellow?
      Yes
      No
Are you a member of your state society?
      Yes
      No
If so, which Society?
Have you served as an Officer, Board member, or committee member in your state society or another professional organization?
      Yes
      No
If so, please explain.
Area of Expertise?
For a list of Committee Chairs, click here.
1st choice:
2nd choice:
Please indicate if you would be interested in serving on a committee that needs volunteers but is not your first or second choice:
      Yes
      No, I am only interested in serving on the committee(s) listed above.

Applications and resumés/curriculum vitaes will be kept on file for two years after the date of receipt.

When completing this application online please mail, fax or email it with a copy of your resumé or curriculum vitae to:

AACVPR National Office
401 N Michigan Ave, Suite 2200
Chicago, IL 60611
Phone: 312-321-5146
Fax: 312-527-6635
aacvpr@smithbucklin.com

 

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