Leadership – Board & Elected Office Application The Fine PrintThank you for your interest in serving on the PAFP Board or as an officer. Requirements for members seeking an elected office are defined in the Academy Bylaws found in the members-only section of the website. Please note: (1) You must be a member in good standing. (2) Elected officers and board members are expected to attend all meetings, virtual and in person – in-state travel is required 2-4 times a year. (3) Conflict of Interest Statements must be completed annually. For questions about PAFP leadership or the application and selection process, please contact Brent Ennis at bennis@pafp.com. APPLICANT INFORMATIONName(Required) First Last Suffix Additional TitlesEmail Address(Required) Email Address Confirm Email Address Mobile Phone(Required)BOARD POSITION OPTIONS(Required)Please select the position for which you are applying. President Elect (1-year term) Foundation President (1-year term) Treasurer (3-year term) Board Director at Large (3-year term) AAFP Delegate (2-year term; must have served on the PAFP Board) AAFP Alternate Delegate (2-year term; must have served on the PAFP Board) UPLOAD CV(Required)Max. file size: 50 MB. Statement of Interest(Required)Please describe your interest in serving on a PAFP committee and share any relevant qualifications and/or experiences. CAPTCHA Leadership – Committee Application The Fine PrintThank you for your interest in serving on a PAFP committee. Please note: (1) You must be a member in good standing. (2) Committee members are expected to attend all meetings, virtual and in person – in-state travel is required 2-4 times a year. (3) Conflict of Interest Statements must be completed annually. For questions about PAFP leadership or the application and selection process, please contact Brent Ennis at bennis@pafp.com. Residents: to apply for a committee position, you must apply through the Residency Assembly that meets in April. If you have any questions, please contact Molly Talley at mtalley@pafp.com.APPLICANT INFORMATIONName(Required) First Last Suffix Additional TitlesEmail Address(Required) Email Address Confirm Email Address Mobile Phone(Required)COMMITTEE OPTIONS(Required)Please select the committee on which you are applying to serve. Resident and Student Affairs Continuing and Professional Development Governmental Affairs and Practice Advocacy Statement of Interest(Required)Please describe your interest in serving on a PAFP committee and share any relevant qualifications and/or experiences. CAPTCHA PAFP Awards Nomination Form The Fine PrintPlease note: (1) Nominee must be a family physician and member of the AAFP/PAFP who has renewed their membership for 2026. (2) Nominee is an exemplary role model who has contributed significantly to the field of family medicine. (3) Selected winners must be able to attend the 2026 PAFP CONNECT Conference on April 3-4, 2026.NOMINEE INFORMATION View Award Criteria and Descriptions Click on the following link to view Award Descriptions and Criteria PAFP Physician Awards Name of Nominee(Required) First Last Credentials Nominee Practice/ School/ Residency Program Name(Required)Nominee Phone(Required)Nominee Email(Required) Enter Email Confirm Email UPLOAD NOMINEE CV(Required)Max. file size: 50 MB. NOMINATOR INFORMATION (If different from above)Name of Nominator First Last Credentials Nominator Practice/Medical School/ Residency Program NameNominator PhoneNominator Email Enter Email Confirm Email View Award Criteria and Descriptions Click on the following link to view Award Descriptions and Criteria PAFP Physician Awards Award Category for this Nomination(Required)Please select the category for which you are nominating a physician. PAFP Family Physician of the Year PAFP Physician Leader of the Year PAFP Exemplary Teaching Award PAFP Community Service Award NOMINATION NARRATIVE(Required)If nominating yourself or another, please explain why this person deserves the award for which you are submitting the nomination. In what ways do they go above and beyond? In what ways do they inspire you or others? (500 words maximum)CAPTCHA