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Fact Sheet for Nominees to the CPE Board of Directors
Please complete all questions to be considered as a nominee for the CPE Board of Directors.
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Name
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Address
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Phone
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Email
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Present Position/Title
Your answer
Number of years involved in physician assessment or physician enhancement
Your answer
Number of years as a CPE member
Your answer
Level of training (degrees/diplomas)
Your answer
Please provide a biographical sketch (maximum 100 words)
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