Form A: AAPA Nominee Recommendation

FORM A: AAPA NOMINEE RECOMMENDATION

Please submit one form for each individual you wish to recommend to the Nominating Work Group for consideration as a candidate in the election for the AAPA Board of Directors. Your recommendation will be contacted by the work group to make sure he or she is willing to be considered for nomination and meets the eligibility criteria (see below). You do not need to complete this form if you are nominating yourself; instead just complete the online application at http://www.formsite.com/aapa2/formc/index.html.

Information about suggested nominee:

* First Name:

* Last Name:

Street Address:

City:

State:

Zip Code:

* Home Phone Number:

Work Phone Number:

* Cell Phone Number:

* Email:

* Position:

President Elect

Secretary-Treasurer (elected in even-numbered years - 2012, 2014)

Director at Large (3 positions elected in odd years: 2011, 2013; 2 positions elected in even years: 2012, 2014)

* Election Year:

Nominees can be recommended for any election, but the individual will need to meet the qualification standards to be eligible for an office.

Information About You, the Nominator
Because only AAPA members recommend nominees, we need the following information (which will remain confidential):

* Your First Name:

* Your Last Name:

* Constituent Organization:

* Your AAPA ID#:

* Your Email:

This form should be received by the Nominating Work Group by OCTOBER 15. The committee needs sufficient time to contact and receive additional information from your suggested nominee before the November 1st deadline. For submissions by mail, send to:

     Chair, Nominating Work Group
     American Academy of Physician Assistants
     2318 Mill Road
Suite 1300
     Alexandria, VA 22314
     (fax) 571-319-4399

Criteria for AAPA Board of Director Candidates

1. According to AAPA Bylaws proposed candidates must meet the following criteria:
ARTICLE XIII Elections. Section 3: Eligibility and Qualifications of Candidates for Elected Positions Other Than Student Director or Nominating Work Group member.

a. A candidate must be a fellow member of the AAPA.
b. A candidate must be a member of an AAPA Chapter.
c. A candidate must have been an AAPA fellow member for the last three years.
d. A candidate must have accumulated at least three distinct years of experience in the past five
    years in at least two of the following major areas of professional involvement:
        i.   An AAPA or constituent organization officer, board member, committee, council, commission, work group, or task force chair
        ii.    A delegate or alternate to the AAPA House of Delegates
        iii.   PA Foundation, Society for the Preservation of Physician Assistant History, or American
               Academy of Physician Assistants Political Action Committee trustee or committee chair,
Physician Assistant Education Association board member or committee chair, or Naitonal Commission on Certification of Physician Assistants board member
        iv.   AAPA board appointees.

2. Specific criteria for the board offices are detailed in AAPA policy.
Candidates for president-elect should have previous experience as an Academy and/or House Officer, board member or commission or work group chair. The candidate must be willing and able to fulfill the time and financial commitments of the office.

Candidates for secretary-treasurer are encouraged to have previous experience in organizational secretarial duties and to have knowledge/experience in general accounting principles.

3. Detailed job descriptions and time commitments may be reviewed on AAPA’s website – search for key word "board"

4. Questions: Email boardelections@aapa.org.

Thank you for participating in AAPA’s governance process.

* Indicates Response Required