2025 Election Committee Volunteer Form

ELECTION COMMITTEE VOLUNTEER FORM
The primary role of the Election Committee is to work with the Speakers to adjudicate any election complaint. Additional roles are to be determined by the Speaker and could include monitoring election reforms, considering future campaign modifications, and responding to requests from the Speaker for input on election issues as they arise.

Individuals will serve 1-year terms, eligible for reappointment for not more than 4 consecutive terms and a lifetime maximum tenure of 8 terms.
All volunteers must agree not to be directly involved in a campaign during their tenure. Please check the boxes below to agree to this requirement.*

If appointed to serve on the Election Committee I agree not to be a candidate or to be directly involved in a campaign during the year in which I am selected to serve.I will not seek re-appointment for the Election Committee for any year in which I intend to be a candidate or to be directly involved in a campaign.
Would you like to serve as Chair of the committee?*

YesNo
Name*

First NameLast Name
Email*
example@example.com
City*
State*
Mobile Number*

Area CodePhone Number
Specialty*
Please select one*

DelegateAlternate DelegateRegional Medical Student DelegateRegional Medical Student Alternate DelegateSectional Resident DelegateSectional Resident Alternate Delegate
Name of the society or section you represent in the House of Delegates*
Previous AMA HOD Committee Service*
Please list previous AMA HOD COMMITTEE service.
Statement of Interest
Not to exceed 150 words.
Headshot for Pictorial Directory (optional)

Browse Files
Upload a headshot (.png, .jpg, or .jpeg) which will be added to the AMA's Pictorial Directory Cancelof
If you have questions or require additional information please contact Patti Wargo, Office of House of Delegates Affairs at patti.wargo@ama-assn.org or 312-464-4463.
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ELECTION COMMITTEE VOLUNTEER FORM