Committee Nominations – Chair or Vice Chair IPEG Committee Vice Chair or Chair Nomination Form Note: IPEG members interested in becoming the Vice Chair or Chair of a committee must meet the following requirements Be a current IPEG member Congress participation (within the last 3 years) Agree to take on a leadership position within a committee for a 2-year term. A member must have served at least 2 years on the committee before becoming eligible for the Chair or Vice Chair positionName of Applicant* First Last Email of Applicant* Phone of Applicant(may be used for Whatsapp group committee communications)Are you a current IPEG member?* Yes No Which leadership position are you seeking?* Vice Chair Chair How many years have you been an IPEG member?* 1-2 3-5 6+ How many years have you served on an IPEG committee as a general member?* Less than 3 3-5 6+ Please identify the committee in which you are seeking a leadership role. Committee Name*-Please select committee name-Business StrategiesCalendar of ContentEducationNew Innovative SpacesPublicationsResearchSimulation & TrainingYoung Surgeons CommitteePlease choose the committee you are interested in participating in. Note: Publication may require additional recommendations.Describe your goals and vision for the committee if selected as Vice Chair or Chair.*Describe previous relevant leadership roles either within IPEG or elsewhere.*By submitting this form, you acknowledge the requirements associated with committee leadership roles.