If you are interested in serving on one of the Governor’s Health Sciences Committees, please complete the application form below. Name Email Cell Phone Number Work Phone Number Mailing Address Planning committee for which you are applying - Select -Advancement and EngagementBiomedical InformaticsCo-Branding & CommunicationsCounseling & AdvisingEmergency Medical ServicesEvaluation & SurveyMedical Laboratory SciencesNursingPharmacyRecruitment & SelectionResearchSports MedicineSteeringStudent & Parent EngagementSummer BridgeSurgical TechnologyOther I am a...(Check all that apply) Parent of a student in the Governor’s Health Sciences Academy Community Member (City of Alexandria) Community Leader Business Community Member Health Care Professional Academy Alumni Current student Current teacher Other What are your interests in serving on an academy committee? Submit Leave this field blank
