AAPA2 - 2023-2024 AAPA HOD Notification Form

2023-24 AAPA HOUSE OF DELEGATES NOTIFICATION FORM

This form certifies that the following organization has elected the following AAPA fellow members as delegates to the House of Delegates.

Delegate terms are from July 1 through June 30 for all COs and the Student Academy.

PA Organization: *

First Name: *

Last Name: *

Today's Date:

E-mail: *

Click here if you are unsure of your organization's apportionment.

List Chief Delegate:

	Name	E-Mail
1.	Name	E-Mail

Note: List your delegates (and extra delegates) below. The number of extra delegates allowed for each delegation is 50% of their apportioned number of seats/votes or 5 extra delegates; whichever is greater.The number of seats apportioned to your organization and the order in which delegates are listed below shall be used to determine who is eligible to vote should the need for an electronic vote occur. Changes can submitted via the delegate change form or by emailing tshoemaker@aapa.org.

Example:
- Your organization has 3 seats in the HOD.
- A chief delegate and 4 delegates are elected.
- If voting electronically, the chief delegate and first 2 delegates listed below are eligible to vote unless a change form is submitted.

List All Delegates (except for the Chief Delegate):

	Name	E-Mail
1.	Name	E-Mail
2.	Name	E-Mail
3.	Name	E-Mail
4.	Name	E-Mail
5.	Name	E-Mail
6.	Name	E-Mail
7.	Name	E-Mail
8.	Name	E-Mail
9.	Name	E-Mail
10.	Name	E-Mail
11.	Name	E-Mail
12.	Name	E-Mail
13.	Name	E-Mail
14.	Name	E-Mail
15.	Name	E-Mail
16.	Name	E-Mail
17.	Name	E-Mail
18.	Name	E-Mail
19.	Name	E-Mail
20.	Name	E-Mail
21.	Name	E-Mail
22.	Name	E-Mail
23.	Name	E-Mail
24.	Name	E-Mail
25.	Name	E-Mail

Do any of your delegates have special requirements such as wheelchair/scooter access in the House that we can accommodate room for? If so, please explain below.

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