TXACP/Services Committee Application Form

Thank you for your interest in serving on a chapter committee. Please fill in the following form with your committee preference and this will be forwarded to the applicable committee chair(s) for review and follow-up.

Following are the requirements to serve on the Committee:

  1. Current ACP Membership
  2. Interest in, and preferably (but not mandatory) experience in inpatient care
  3. Time commitment of approximately 2 hours per month including teleconference and assigned tasks
  4. Active participation in monthly teleconferences.  Cannot miss more than two sessions during the year (additional sessions may be excused at the Chair’s discretion)
  5. Willingness to complete tasks assigned as part of the Committee’s function or of it’s Work Groups
  6. In-person attendance of the Committee Meeting on the sidelines of the Texas ACP Annual Meeting is highly encouraged but not mandatory.

First Name: *
Last Name: *
ACP Membership #: *
Email: *
Mailing Address:
Practice Setting (use SHIFT + Select to choose multiple): *
Prior Texas ACP or ACP Committee Experience:
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Committee Preference (Use SHIFT + Select to choose multiple options): *
Please describe what makes you a good candidate to serve on this committee and what your specific interests are:
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Member Feedback Requested on ACP Resolutions

The Fall BOG Meeting is in September and members are encouraged to provide feedback via chapter survey by September 23.

Mark Your Calendar!

Texas Chapter Annual Scientific Meeting
November 17-18, 2018, JW Marriott Austin
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