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New Jersey Academy of Family Physicians
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Commitee Nomination Form

Please use this form to volunteer for an NJAFP committee or to nominate a colleague.

Name *

First

Last

Email *

Phone

Area of Interest *

Membership Information and Member Services
Legislative and Governmental Advocacy
FamMed Forum/Annual Meeting
Perspectives Magazine
Continuing Professional Development/Continuing Medical Education
Volunteering/Getting Involved in NJAFP
Practice Improvement and Practice Transformation Services
Student and/or Resident Issues
Communications

What do you want to tell us about you/your nominee?

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CONTACT NJAFP:
224 West State Street
Trenton, NJ 08608
Phone: 609/394-1711
Fax: 609/394-7712
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