Constituent Organization Award

2010 CONSTITUENT ORGANIZATION AWARD

Deadline for submissions is January 15, 2010

The Constituent Organization Award of Excellence recognizes the individual constituent organizations that take a proactive approach to the students with whom they interact and go above and beyond in their efforts to educate and include them.

The winning organization is recognized and given a plaque recognizing its outstanding dedication to PA students at the Assembly of Representatives meeting at AAPA’s Annual PA Conference. This award is sponsored by the Student Academy of the AAPA.

Judging Procedures:

The Student Board of Directors will evaluate each entry at its spring board meeting. The decision will be announced at the Student Academy Assembly of Representatives meeting at AAPA’s Annual PA Conference.

Application Requirements for Consideration:

· Part 1 - Constituent Organization Award Application Form

· Part 2 - Narrative Component

1. Cover the time period of November 1, 2006, through November 30, 2009
(the past three years).

2. Limit narrative component to 3 pages.

                   3.       Describe the efforts of you constituent organization in the areas listed below.
                        Include examples of what your constituent organization has done, how it was
                        done, and what results were accomplished related to students. Identify
                        accomplishments or areas of particular advancement in meeting defined
                        goals, and addressing areas of need. Activities should attract students to
                        and information students about the PA profession, and/or promote the
                        professional and/or personal development of PA students.

a. Student development

i. Board and committee involvement

ii. Membership recruitment and retention activities

b. Student-oriented workshops

c. National student involvement

i. Representation at AAPA-sponsored events

ii. Leadership

· Part 3 – Essay question

1. Why should your constituent organization receive the Constituent
Organization Award?

               2.       If you constituent organization has received this award in the part, how
                    have you used the awards to enhance your constituent organization’s
                    programming and development?

Part 1 - Constituent Organization Application Form

Contact Information:

Name of Constituent Organization:

Position of principal applicant:

Position of applicant:

Applicant phone number:

Applicant e-mail address:

Membership Information:

Number of Student Members:

Amount of Student Membership Dues:

Number of Fellow Members:

Amount of Fellow Membership Dues:

Total Number of Members:

Number of all PAs in the state or constituency:

What percentage of the total number of PA students in your state/constituency belong to your constituent organization?

List the membership benefits provided to the constituent organization's student members.

Student Representative Information:

Did a representative of your organization attend the 2009 AAPA annual conference?

No

Yes

If a student did attend, did he or she receive funding from your organization and what amount was received?

No

Yes

Did a student representative of the constituent organization attend any other PA organization meetings?

No

Yes

Please list which meetings the student attended:

If a student attended other meetings, did he or she receive funding from your organization and what amount was received?

No

Yes

Leadership and Leadership Development:

Does the constituent organization have a written job description for its student leadership position? If yes, please attach a copy in the space provided below.

No

Yes

Does the constituent organization provide leadership training for current and potential/future constituent organization leaders or student leaders? If yes, please attach a description of your training in the space provided below.

No

Yes

Does the constituent organization have its leadership participate in an annual strategic planning/ direction setting weekend retreat/meeting? If yes, is the student representative encouraged to participate?

No

Yes

Does the constituent organization have an established future leader mentoring program? If yes, please attach a description of the program in the space provided below.

No

Yes

How long has the organization had a program for student leadership development?

Membership Recruitment Information:

Does the constituent organization recruit new student members using direct mailings to nonmembers? If yes, how many times a year do you do so?

No

Yes

Does the constituent organization recruit new student members using phone calls to nonmembers? If yes, how many times a year do you do so?

No

Yes

Does your constituent organization recruit new student members using e-mails to nonmembers? If so, how many times a year do you do so?

No

Yes

Does your constituent organization recruit new student members using advertising in PA publications?

No

Yes

Please specify any other methods your constituent organization uses to recruit new student members:

Scholarship:

Does your constituent organization offer scholarships? If yes, what is the total number and dollar amount you award each year?

No

Yes

Does your foundation offer scholarships? If yes, what is the total number and dollar amount you award each year?

No

Yes

Are there any restrictions on your scholarships?

State residency

Membership in organization

Other (please specify)

What are the funding sources for your scholarship program and the amount that they contribute?

	$ Amount	Additional Information
Donations from members
Part of annual budget
Donation from corporations
Other (please specify)

Total number of scholarships offered by the constituent organization:

Total number of scholarships offered by the foundation:

* Indicates Response Required