YOU CAN VOLUNTEER

Count Me In!
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I would like to participate in or learn more about the following area(s):
Please Print Clearly:

Name:___________________________
Address: _________________________
Email:___________________________
Telephone Number__________________

Please check off your areas of interest.
Please fax it to 772-388-3457
or email us at TheAASPA@aol.com

_I am interested in learning about the Board of Directors
(President-elect, Secretary, Treasurer, Student Director, Director-at-large)

_Scholarship Committee
Judge scholarships (yearly). Obtain scholarship sponsorship (ongoing).

_Mentor Program
Advise and mentor an up and coming AASPA Student or Resident. Usually done via email. You will receive a "AASPA Surgical Mentor" certificate.

I would like to mentor:
_PA Resident (open to Fellow Members only)
_PA Student (open to Fellow & Resident Members)
_Pre-PA Student (open to all members)

_Website Committee

_Reimbursement Committee

_Student Activity Committee

_Corporate Relations Committee

_Membership Committee
Help to recruit and retain Fellow, Resident, Student, Physician Partner, and
Pre-PA Members.

_CME Committee
Help to organize and advertise our October 2005 CME in San Francisco.

_I would like to speak at a CME meeting. Topic: __________________

_Outreach team
Marketing & Exhibiting: Help us staff our exhibit booth at regional surgical &
PA meetings.
Speak to local hospital interested in PA’s or local PA programs

_I would like to write an article or editorial
_for the Sutureline newsletter _for the website

_I am interested in teaching PA students at my place of employment
(i.e. establishing a clinical rotation site for PA Students)

_ I would like to subscribe to the AASPA BOD E-mail group.

_ I would like to participate in the AASPA BOD Telephone Conferences

_ I would like to attend the Spring AASPA BOD Meeting (Usually held in late March)

_I would like to participate in the AAPAs House of Delegates as an AASPA Rep.

_ Nominating Committee

_Committee on Surgical Education & Research

_I would like to donate to the Surgical PA Marketing Fund

_I would like to participate in a AASPA Specialty Caucus. Your specialty_____

_ I have a new idea for AASPA:

You will hear from an AASPA team member within 5-7 days.

COUNT ME IN!
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THANK YOU!

Gerald T. Simons, PA-C
Immediate Past President