Webform Part 1: Leadership Body Selections & Biographical Data First Name Middle Name Last Name Address City/Town State/Province State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingOther… Enter other… Country Country - None -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan MarinoSarkSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkmenistanTurks & Caicos IslandsTuvaluTürkiyeU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsOther… Enter other… E-Mail E-Mail Confirm email First Governance Body Selection - Select -Membership CommitteeStandards and Ethics CommitteeWorkforce on Adult Cardiac and Vascular SurgeryWorkforce on Annual MeetingWorkforce on Cardiothoracic Surgery Practice ModelsWorkforce on Career DevelopmentWorkforce on Coding and ReimbursementWorkforce on Congenital Heart SurgeryWorkforce on Continuing Education and Maintenance of CertificationWorkforce on Critical CareWorkforce on Diversity, Equity, and InclusionWorkforce on Evidence Based SurgeryWorkforce on E-Learning and Educational InnovationWorkforce on General Thoracic SurgeryWorkforce on Health Policy, Reform, and AdvocacyWorkforce on International EducationWorkforce on Media Relations and CommunicationsWorkforce on Multidisciplinary Team CareWorkforce on National DatabasesWorkforce on Patient SafetyWorkforce on QualityWorkforce on ResearchWorkforce on Surgical Treatment of Adults With Congenital Heart DiseaseWorkforce on Surgical Treatment of End-Stage Cardiopulmonary DiseaseWorkforce on Technology and InnovationWorkforce on Thoracic Surgery Resident DevelopmentSTS-PAC Board of Advisors Second Governance Body Selection - None -Membership CommitteeStandards and Ethics CommitteeWorkforce on Adult Cardiac and Vascular SurgeryWorkforce on Annual MeetingWorkforce on Cardiothoracic Surgery Practice ModelsWorkforce on Career DevelopmentWorkforce on Coding and ReimbursementWorkforce on Congenital Heart SurgeryWorkforce on Continuing Education and Maintenance of CertificationWorkforce on Critical CareWorkforce on Diversity, Equity, and InclusionWorkforce on Evidence Based SurgeryWorkforce on E-Learning and Educational InnovationWorkforce on General Thoracic SurgeryWorkforce on Health Policy, Reform, and AdvocacyWorkforce on International EducationWorkforce on Media Relations and CommunicationsWorkforce on Multidisciplinary Team CareWorkforce on National DatabasesWorkforce on Technology and InnovationWorkforce on Patient SafetyWorkforce on QualityWorkforce on ResearchWorkforce on Surgical Treatment of Adults With Congenital Heart DiseaseWorkforce on Surgical Treatment of End-Stage Cardiopulmonary DiseaseWorkforce on Thoracic Surgery Resident DevelopmentSTS-PAC Board of Advisors Third Governance Body Selection - None -Membership CommitteeStandards and Ethics CommitteeWorkforce on Adult Cardiac and Vascular SurgeryWorkforce on Annual MeetingWorkforce on Cardiothoracic Surgery Practice ModelsWorkforce on Career DevelopmentWorkforce on Coding and ReimbursementWorkforce on Congenital Heart SurgeryWorkforce on Continuing Education and Maintenance of CertificationWorkforce on Critical CareWorkforce on Diversity, Equity, and InclusionWorkforce on Evidence Based SurgeryWorkforce on E-Learning and Educational InnovationWorkforce on General Thoracic SurgeryWorkforce on Health Policy, Reform, and AdvocacyWorkforce on International EducationWorkforce on Media Relations and CommunicationsWorkforce on Multidisciplinary Team CareWorkforce on National DatabasesWorkforce on Technology and InnovationWorkforce on Patient SafetyWorkforce on QualityWorkforce on ResearchWorkforce on Surgical Treatment of Adults with Congenital Heart DiseaseWorkforce on Surgical Treatment of End-Stage Cardiopulmonary DiseaseWorkforce on Thoracic Surgery Resident DevelopmentSTS-PAC Board of Advisors Will You Be a CT Surgery Resident Through January 2025? Yes No Biosketch (500 character limit) Specific Qualifications (500 character limit) Upload your most recent CV One file only.20 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank