Thank you for agreeing to serve a planner and/or faculty member for the webinar: Digital Divide: The Role of Digital Equity in Health Disparities. Please complete the following form to confirm your acceptance of your invitation to plan this activity.

BEFORE YOU BEGIN: please check your profile on the AAAAI website to confirm that your name, contact information and online disclosure form are up to date, and make any changes that are needed. Make sure that you have logged in before completing this form.

To start, download the Blank W-9 form below. You will upload your completed form as part of completing this agreement.