ATA Secretary-elect Nominee Form

By December 20, 2021 Awards and Leadership Press

ATA Secretary-Elect Nominee Form 

Qualifications

Before completing this form, please confirm that you:

  1. Have been an ATA member for five years
  2. Chaired a committee
  3. Attended five ATA meetings

Conflicts of Interest

The Secretary serves as a member of the Board of Directors and agrees to follow the policies regarding Conflicts of Interest and divesting requirements.  Please be sure to update your governance forms to disclose any potential Conflicts of Interest and/or leadership positions in other organizations.

2022 Secretary-elect Nominee Form

  • Nominee Name & Contact Information:
  • (MD, PhD, DO, etc)
  • Optional
  • If not please complete the 2 minute form here* - https://members.thyroid.org/Shared_Content/Sign_In.aspx?WebsiteKey=c617c2af-4682-4907-b140-bb0409b2ec46&LoginRedirect=true&returnurl=%2fCOI_Forms
  • Conflict of Interest Policies for Secretary-elect

    If nominated for Secretary-elect, please initial next to each of these nine items:

  • CONFLICT OF INTEREST POLICIES THAT PERTAIN TO OFFICERS OF THE ATA BOARD OF DIRECTORS
    The Officers of the ATA Board of Directors (Executive Committee) will take the following steps during their terms of office to avoid actual or perceived conflicts of commitment and ensure their unimpeded active involvement in issues of importance to the Association:
  • ATA EXECUTIVE COMMITTEE (ATA OFFICERS) INTERACTION WITH INDUSTRY PERMITTED AS FOLLOWS:
  • Drop files here or