Delegate Candidate Application 2024

Thank you for your interest in serving your District/Section/specialty with OSMA.

What position(s) are you seeking:

(Deadline to apply is Feb. 6,2024)
Delegate
Alternate Delegate
Districts 1, 3, 5 and 7 elect District Councilors this year.
Check if self-nominating for District Councilor

What district/section/specialty do you wish to represent?

Your medical specialty:

Your practice setting:

Personal Statement: (250 word maximum)

First Name
Last Name
Designation (MD, DO, MPH, FACS, etc.)
Email Address
Mobile Phone
Organization
   - denotes required fields