2009 AAPA
House of Delegates
Notification Form

This certifies that the following constituent organization has elected the following AAPA fellow members as delegates and alternates to the San Diego House of Delegates.

PA Organization

Your name

Your e-mail address

Today's date

Please submit only as many delegates as are apportioned to your organization. Click here if you are unsure of your apportionment.

List Chief Delegate

	Name	E-mail

List Delegates

	Name	E-mail
1
2
3
4
5
6
7
8
9
10
11

List Alternates

	Name	E-mail
1
2
3
4
5
6
7
8
9
10
11
12

Special Requirements

Do any of your representatives have special requirements such as wheelchair/scooter access in the House that we can accomodate for? If so, please let us know here.

Thank you for filling out the AAPA House of Delegates Notification Form. If you have any questions, contact Tom Shoemaker at tshoemaker@aapa.org.

Indicates Response Required

2009 AAPA House of Delegates Notification Form

2009 AAPA
House of Delegates
Notification Form