2026 Associate Member Candidate Form

Completion of this form indicates your intent to be a candidate for the SMFM Associate Member Representative To be considered for this position you must be an Associate member. An Associate member is an SMFM member in good standing who is currently enrolled in an ABOG approved MFM or combined MFM-genetics fellowship or has completed a fellowship but is not yet board certified in MFM. Responses to the questions will be disseminated to the voting membership if you are accepted as a candidate as a summary of your qualifications for the position. No personal or contact information will be disseminated.

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* 1. Contact Information

Name and Title:

Fellowship Program:

Date of Graduation (actual or expected):

Are you currently board certified in MFM?

Email Address:

Cell Phone Number:

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* 2. Please write a brief statement indicating your interest in serving and any special qualifications you have for the position. (< 250 words)

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* 3. What would you like to accomplish if selected? (< 250 words)

Responses to the questions above will be disseminated to the general membership if you are accepted as a candidate as a summary of your qualifications for the post.