Society of Pediatric Psychology Annual Meeting (SPPAC)
Chair-Elect Nomination Form


Nominations due Monday, December 19, 2022.


Thank you for your interest in the position of SPPAC Program Chair-Elect!

All questions below are optional to complete. You will see that we included questions that will 1) help us work towards ensuring that our appointed board positions represents our membership and the patients and families we serve, and
2) provide us with the ability to evaluate how we are doing with this effort across SPP leadership and committees moving forward. Consistent with SPP’s mission statement and strategic drivers, these are questions based on the ADDRESSING model, as well as career information, that will help us work towards this goal of forming leadership positions and committees based on merit and representation.

SPPAC Chair-Elect Nomination

"*" indicates required fields

5.How would you describe your stage of career?
6. How would you describe your current place of work?

7. How would you describe the type of work in which you are engaged (check all that apply?)
8.Would you consider yourself an international member of SPP?
10.With which racial/ethnic groups do you identify – check all that apply*
11. How do you identify?*

12.How would you define your sexual orientation?

13.How would you describe yourself?

14. If not born in the USA, on what continent(s) were you born and raised (check all that apply)?
15. Primary language(s) spoken (check all that apply):
16. Are you a first-generation scholar (i.e., parents did not go to college)?
17. What religious background, if any, do you most identify with?

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