Seal of the American College of Epidemiology, 1979: chronos, topos, demos American College of Epidemiology           
 Committee Participation Form           

  Participating in the College's governance activities provides you with the opportunity to test and expand your leadership skills, increase your professional contacts, and advance the profession of epidemiology. ACE is your professional organization – we hope you will take an active role in its development.

Please complete and submit this form
or print, complete, and mail or fax it to the address below
(please type or print clearly).

 
 First name
Middle name or initial
Last name


Title


Degrees


Institution

 
 

    
   City or Town


State or province


Country

    
  E-mail
Telephone
Fax
 I would like to participate in the following ACE Committees
 (please check all that apply):

ADMISSIONS

AWARDS

COMMUNICATIONS

EDUCATION

ETHICS and STANDARDS
      of PRACTICE

FINANCE

MEMBERSHIP
 

MINORITY AFFAIRS

NOMINATING

POLICY

PUBLICATIONS

Since there are sometimes more volunteers than available openings, please use the space below to summarize briefly your past participation in the College, your qualifications or special interests for specific committees, or anything else that would be useful to know.

Please click the Submit button to e-mail this form to the ACE office
or send the completed form by mail or fax to:

American College of Epidemiology
1500 Sunday Drive, Suite 102
Raleigh, NC 27607
Ph: 919-861-5573, Fax: 919-787-4916
info@acepidemiology.org

Updated 08/05/03 vs