Volunteer Participation Form for the Doctor's Dilemma℠ Competition at the ACP Internal Medicine Meeting 2016

ACP ID:

Name:*

E-Mail:*

Phone:*

Best way to contact me:*     E-mail    Phone

Please indicate your interest in and availability for each of the volunteer roles:*

Please briefly describe any similar past experience (volunteer or professional): *

* I understand that I must participate in a pre-meeting volunteer conference call in April, and an on-site volunteer training session at the ACP Internal Medicine Meeting 2016 in Washington, DC on Thursday, May 5, 2016 at 10:45 AM EDT.