About YouYour Name(Required) First Middle Last Degree, Certification or other post-nominals (e.g., MD, DO, PhD)Specialty (if applicable)Please leave blank if not applicable.PronounsYour Email Address(Required) AMSA ID (optional)For the AMSA ID, helper text used elsewhere is: If you have a six-digit AMSA ID, you can enter it here. Have an AMSA ID but don’t know it? You can find it here: https://amsa.org/get-amsa-id or text AMSAID to 615-265-0086 (U.S. only).Mobile Phone(Required)SMS Messaging? I accept messaging from AMSA via SMS / text.I am willing to receive information and updates about these judging opportunities via SMS / text messaging.School / Institution / Organization(Required)Stage of Training(Required)Please choose which level best describes your current stage of training.Practicing Physician / FacultyGME-1GME-2GME-3GME-4GME-5+MS1MS2MS3MS4MS5+OtherJudging at Future Physicians for ChangeFor which of the following would you be willing to serve as a judge?(Required) Sim Challenge (in-person) Poster Session (in-person) Poster abstracts (virtual) Oral presentations (in-person) Innovation Challenge (in-person) Poster categoriesPlease choose any specific categories you are particularly interested in judging. You may select more than one. Select All Basic, Translational, and Clinical Research Community Engagement and Public Health Impact Health Policy, Advocacy, and Justice Medical Education and Curriculum Innovation Organizational and Chapter Initiatives Reproductive Justice and Abortion Advocacy General availabilityMore specific scheduling information will be available later. Select All Dec. 10, evening (Thursday PM) Dec. 11, morning (Friday AM) Dec. 11, evening (Friday PM) Dec. 12, morning (Saturday AM) Please briefly describe any past experience or particular qualifications for serving as a judge.(Required)FP4C judging agreement I agree to the terms of participation below, including associated non-discrimination, anti-harassment, and event participation policies.I agree to conduct my evaluations of students’ work ethically and respectfully, honoring the diversity of presenters and participants and the various stages of their developing projects. I agree to abide by AMSA’s non-discrimination policy as outlined in the FP4C terms of participation as well by AMSA’s policies on non-discrimination and inclusion as outlined in the AMSA’s Preamble, Purposes and Principles document. I also agree to abide by the anti-harassment policy as defined in the FP4C terms of participation. Any additional information, questions, or concerns?
