Leaders in Academic Medicine Program 2023-2024 Application

LAMP is a leadership development program for faculty and staff tailored to our needs as academic medicine professionals, providing you with the tools you need to excel in leadership roles.

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Pre-Screening Questions
What is your affiliation with the School of Medicine? *

Pre-Screening Questions
What is your affiliation with the School of Medicine? A&M Employed Faculty Affiliate/Adjunct Faculty A&M Employed Staff Affiliate Employed Staff
Have you been employed/affiliated with the School of Medicine for at least two years?

Have you been employed/affiliated with the School of Medicine for at least two years? Yes No
How long have you been with the School of Medicine?

How long have you been with the School of Medicine? 2-5 years 5-10 years 10-15 years 15-20 years 20+ years
Contact Information

Prefixes (Dr., Mr., Mrs., Ms., etc)
Name Name First Last
Credentials: (MD, MBA, etc)
Professional Title
Department/Organization Name
Business Address Business Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business Phone Business Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Email
Please upload your current CV or Resume.

Attach Files
Please upload your Supervisor Authorization Form.

Attach Files
If you have a letter of recommendation, please upload it here. (Optional)

Attach Files

Leaders in Academic Medicine Program 2023-2024 Application

Leaders in Academic Medicine Program 2023-2024 Application

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