Form N -- AAPA Nominating Committee Candidate Application

* Name

* Address

* E-mail Address

* Telephone

* AAPA Membership Number

Years as AAPA Fellow Member:
(Candidates must be AAPA fellow members for at least 5 years)

PROFESSIONAL EXPERIENCE

Candidates must meet the following criteria in order to be considered for the Nominating Committee.

A) Have accumulated at least five years of experience in the past seven years in at least two of the following areas of professional involvement: 1) a constituent chapter officer, board member, or committee chair; 2) a delegate to the AAPA HOD; 3) an AAPA committee, council, congress, or ad hoc group member; 4) an AAPA officer, director-at-large or HOD officer; 5) specialty group or caucus group officer, board member, or committee chair; 6) PA Foundation committee chair or trustee; or 7) AAPA external liaison organization.
B) A Nominating Committee member cannot hold another elected office or standing committee position in the AAPA during the time of service on the Committee.

* List your five years of experience that meets the Nominating Committee criteria listed above. List any present or previous leadership experience, including but not limited to organizations that you have served as a committee, council, or board member. Please include the organization name and dates of office.

* Have you ever been a delegate to the AAPA House of Delegates?

Yes

Years Served

Write a platform statement explaining why you wish to serve on the Nominating Committee. Tell us why you are running, and what you hope to bring to the committee if you are elected.

Are there any additional volunteer experiences that will make you a valuable committee member, such as serving on a community/hospital board or committee, church leadership, youth group leader, etc.

Please attach your CV/resume as either a Word document or a PDF file. If your browser does not have this capability, please e-mail it to tshoemaker@aapa.org.

* I am an AAPA fellow member. I understand that, if selected for service, I will be required to attend AAPA's Leadership Summit in late July (see AAPA's master calendar for exact dates), in Washington, D.C.

Yes

* Date

Candidates must submit their applications by MARCH 25 in order to have their materials printed the the HOD handbook. If you miss the deadline, you may declare your candidacy on the floor of the HOD and provide your own written materials for dissemination at the House.

* Indicates Response Required