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Protégé Application Questions:
Name
Company
Job Title
Email
Phone Number
City and State
Country
- Select -
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Congo-Brazzaville
Croatia
Cuba
Cyprus
Czechia (Czech Republic)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (fmr. "Swaziland")
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine State
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Experience Level
- Select -
< 1 year
1 to < 5 years
5 to < 10 years
10 to <15 years
15 to < 20 years
20+ years
Industry/Focus
- Select -
Healthcare Technology Management
Sterilization - Hospital
Sterilization - Industry
Medical Device Manufacturing
Government/Regulatory
Please list your job function:
- Select -
Equipment, maintenance
Sterilization and/or sterility assurance
Quality management
Research & development
Regulatory affairs/compliance
Clinical care (including surgery)
Customer or client service/support
Infection prevention & control
Training or education
Acquisition/installation/integration
Information systems and/or cybersecurity
Manufacturing or production
Certification, licensure, standards or accreditation
Risk management
Sales and/or marketing
Academic research
None of the above
What certifications and/or degrees do you currently hold?
What certifications and/or degrees do you plan to seek in the future?
Please briefly explain why you wish to be a protégé in this program:
Please briefly describe a long term career goal:
Please select the areas that you would like to receive guidance from a mentor:
Select all applicable items
Career planning
Job-specific guidance
Professional networking
Leadership Development
Communication skills (written, oral, etc.)
Other
Other area(s) to receive guidance:
Any additional comments you think may be helpful in pairing you with an AAMI Mentor:
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