Resident Committee Application

Resident/Fellow Application to join a committee, TF or CoP

Please complete the form below to apply to join a CORD committee.
CORD Committee Member Information
- ALL Applicants to a CORD group must be a CORD member representative.
- Applicants will hear of their status by the fourth business day of the next month
The deadline for applications: Open All Year

For more information on a committee, task force, or community of practice please visit the committee information page.

CORD welcomes the participation of residents and fellows on CORD committees and task forces. Residents and fellows are required to submit a letter of support from their program director and a copy of their CV as a part of their application. Incomplete applications without the required documentation will not be considered.

All committees, task forces, and communities of practice accepting resident/fellow participation are listed below. If a committee is not listed it is not available for a resident/fellow. Resident and Fellow member representatives of CORD are only allowed to serve on ONE committee at a time. You may select up to 3 committees below to submit your interest, however, you can only be selected to join ONE committee.
Full Name *

First NameLast NameDegree
Email*
example@example.com
Cell Phone*

Area CodePhone Number
Program Name*
Resident/Fellow Committee Selections*

Academic Assembly Program CommitteeAdvising Students Committee in EM (ASC-EM)Application Process Improvement Task ForceBylaws CommitteeDiversity & Inclusion Task ForceDual Training Community of Practice (EM/IM)Education CommitteeMedical Education Fellowship Community of PracticeIDEAS CommitteeInformatics (IT) CommitteeOsteopathic Community of PracticeRegional Meetings Working GroupRemediation CommitteeResearch & Scholarly Productivity CommitteeResidency Closure Task ForceSimulation Community of PracticeSocial Media & Informatics CommitteeTransition of Care Task ForceWell-Being Committee
Letter of Interest (why are you interested in joining this committee, 250 words max)*

0/250
Please provide any qualifications, background, and other information we should take into consideration in reviewing your application?*

0/250
Program Director Letter of Support*

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Curriculum vitae*

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Resident/Fellow Application to join a committee, TF or CoP