Governance Committee

APPD 2025 Call for Governance Committee Members

Contact Information

First Name:(Required)

Middle Name:

Last Name:(Required)

Degree(s):(Required)

Institution:(Required)

Title:(Required)

Email(Required)

Address:(Required)

City:(Required)

State/Province:(Required)

Zip/Postal Code:(Required)

Office Phone:(Required)

Mobile Phone:(Required)

Position Applying For:(Required)

Two-Year Term (2026-2028)

Three-Year Term (2026-2029)

Either Two or Three Year Term

Application Materials

Please enter information for each area in the text box.

Demonstrated Standing in the Pediatric Education Community(Required)

Leadership accomplishments, peer recognition, contributions to the field.

Assessment and Judgment Capabilities(Required)

Examples that illustrate the nominee’s ability to exercise sound judgment in evaluating the qualifications, readiness, and leadership potential of others. (eg. service on faculty or executive search committees, prior experience on APPD Nominations Committee)

Commitment to Equity, Inclusion, and Excellence(Required)

How the nominee has advanced or actively contributed to equity, inclusion, and excellence within APPD, pediatric GME, or their home institution.

Relevant Experience(Required)

Specify roles held, years of service. Please feel free to share major responsibilities or accomplishments in each role.

Curriculum Vitae

File(Required)

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 128 MB.

APPD 2025 Call for Governance Committee Members

Contact Information

Application Materials

Curriculum Vitae

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