Institutional Profile Form

All membership category positions listed below are covered by the AUPN annual dues and therefore are entitled to all AUPN benefits. This includes receiving the Saturday newsletters and access to all educational offerings.

If there is not an individual in a specific role, please leave blank.

Please contact neuro@aupn.org with questions.

Institution Contact Information:

Neurology Department Chair (billing contact)

Residency Program Director

Clerkship Director

Child Neurology Residency Program Director

Research Program Director

VA Director

Vice Chair
One Vice Chair is allowed to serve as a member of AUPN. Please enter the Admin Vice Chair or a Vice Chair of the Department Chair's choosing.

Please note: Program Directors who are also Vice Chairs should be listed in the Program Director role and another individual should be identified for the Vice Chair Position.