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Volunteer Participation Form for the Doctor's Dilemma® Competition at Internal Medicine 2014

ACP ID:

Name:*

E-Mail:*

Phone:*

Best way to contact me:*     E-mail    Phone

Please indicate your interest in and availability for each of the volunteer roles:*

Date and TimeMaster of Ceremonies JudgeGame AssistantGreeter
Thursday, April 10, 2014
3:30 p.m. to 6:30 p.m.
Friday, April 11, 2014
3:30 p.m. to 5:15 p.m.
Saturday, April 12, 2014
4:30 p.m. to 6:30 p.m.
N/A

Please briefly describe any similar past experience (volunteer or professional): *

* I understand that I must participate in a pre-meeting volunteer conference call on Wednesday, March 5, 2014 at 10:00 a.m. EST and an on-site volunteer training session at Internal Medicine 2014 in Orlando on Thursday, April 10, 2014 at 10:30 a.m. EST.

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