Database of Potential Leaders for Constituent Organizations

The AAPA’s Leadership and Professional Development (LAPD) Council connects constituent organizations (state and specialty PA associations) with potential leaders who practice in their state or specialty. If you are interested in constituent organization leadership opportunities, please complete this form. We will share your preferred contact information and a copy of your CV with constituent organization officers in your state or specialty.

Name

AAPA Membership #

PA Program Attended

Please choose the constituent organization(s) you want us to notify about your interest in volunteering.

State Organization

AAPA recognized Specialty Organizations

AAPA Caucuses

Leadership History (complete all that apply to your leadership experiences)

PA Organization

Position

Which year(s)?

Community Organization

Position

Which year(s)?

National Organization

Position

Which year(s)?

Other (List any additional positions you believe would be of interest to the constituent chapter receiving this information.)

Preferred Contact Information (this will be provided to your constituent organization)

E-mail

Phone Number

Address 1

Address 2

City

State

Zip Code

Current CV

Please upload your current CV here or e-mail it to kerb@aapa.org.