Get Asa House Of Delegates Nomination Form

Filling out the ASA House Of Delegates Nomination Form online can be an important step for medical students seeking to represent their peers in the ASA. This guide provides clear instructions to help users complete the form efficiently and accurately.

Follow the steps to successfully complete the nomination form.

1. Press the ‘Get Form’ button to access the nomination form and open it for completion.
2. Begin by filling in the candidate's first and last name in the designated fields.
3. Indicate ASA membership status by checking either 'Yes' or 'No'.
4. Enter the graduation year in the specified field.
5. Provide your complete address, including city, state, and zip code.
6. Fill in contact details such as phone number, fax number, and email address.
7. List the medical school attended, alongside the city and state where it is located.
8. Remember to obtain a letter of support from the Anesthesiology Department Chair or a qualified member.
9. Review the delegate responsibilities to confirm your commitment to the role.
10. Ensure that all required signatures, including that of the medical school representative and yourself, are included.
11. Fill in the date of signing the form.
12. Once completed, save the changes. You may also choose to download, print, or share the form as needed.

Submit your ASA House Of Delegates Nomination Form online to take a proactive step in your medical career.