Member Engagement Work Group Application

Application deadline is January 22, 2023.
Name*
First Last Suffix
APGO Member Since*
Institution*
Department*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Please upload the following as a single PDF document:
- Letter of intent (2-page maximum) addressed to Arthur Ollendorff, MD, APGO President, that describes the reason for applying and anticipated contributions as a work group member
- Current curriculum vitae
Attachment*
Max. file size: 50 MB.