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RJOS Ambassador Request
Please help us find the best Ambassador for you for you by answering the questions below!
Last Name *
Your answer
First Name *
Your answer
Are you an active RJOS member? *
Best email address *
Your answer
Best phone number *
Your answer
Institution/Program where you are CURRENTLY training *
Your answer
Are you graduating this summer and entering practice in 2019? *
Where will you be practicing starting Fall 2019? *
Your answer
What specialty(ies) will you be practicing? *
Required
Which best categorize the practice you will join? *
Required
Are you planning on collecting for ABOS Part 2 in 2020? *
Will you be expected to actively perform research (ie is it in your contract?) *
Please specify which platforms you are active in via social media. *
Required
Do you have children? *
Professional organizations you are a member of:
Your answer
Which areas are of most interest to focus on during this 1 year mentorship? (select 5) *
Required
Anything else you want us to know about you that will help make this a success? Leave it here!
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