Student Society Registration

A registered student society is required for Challenge Bowl, the Outstanding Student Society Award, and the Conference Travel Grants.

To be fully registered, a society must submit the following information:
* Four required officers - President, Student Academy Representative, State Chapter Student Representative, and Diversity Chair - all must be filled by AAPA studnet members

*All optional positions must be filled by AAPA members

*At least 4 unique students filling the different positions

If you have any questions please contact Student Academy Staff Advisor (571-319-4310) or email students@aapa.org.

Please check the status of your student society registration here: https://www.aapa.org/about/aapa-governance-leadership/student-academy/registered-student-societies/

Please note: Any email addresses entered into this form that have opted-out of AAPA email notifications will not receive marketing emails and other emails from AAPA.

Student Society Information

Email address to receive a copy of the completed form as confirmation: *

PA Program: *

Month your cohort starts clinical rotations *

Year your cohort starts clinical rotations *

Faculty advisor name: *

Faculty advisor email: *

Student Society Officer Information:

1. President (REQUIRED POSITION)

President Name: *

AAPA Member #: *

President Email: *

2. Vice President (optional, but if filled, the student must be an AAPA student member):

VP Name:

AAPA Member #:

VP Email:

3. Secretary (optional, but if filled, the student must be an AAPA student member):

Secretary Name:

AAPA Member #:

Secretary Email:

4. Treasurer (optional, but if filled, the student must be an AAPA student member):

Treasurer Name:

AAPA Member #:

Treasurer Email:

5. Student Historian (optional, but if filled, the student must be an AAPA student member):

This position serves as a liaison to coordinate activities between their student society and the Society for the Preservation of Physician Assistant History. The student historian shall report all activities to the Society for the Preservation of Physician Assistant History

Historian Name:

AAPA Member #:

Historian Email:

6. State Chapter Student Representative (REQUIRED position):

This officer will attend the State Chapter Meeting on behalf of the program and report back on the state chapter's work. For more information on your state constituent chapter policies, contact your local chapter.

SCSR Name: *

AAPA Member #: *

SCSR Email: *

7. Outreach Chair (optional, but if filled, the student must be an AAPA student member):
This position serves as a liaison to coordinate activities and public relations efforts between their student society and external groups and works to promote the profession with these external groups. The OC shall report all activities to both the Student Academy Director of Outreach. The responsibilities of the OC should include, but are not limited to the following: Coordinate activities and public relations efforts between the student society and external groups; these groups include, but are not limited to: other medical professionals (MD, DO, PT, OT, nurses, speech, etc.), city organizations, county organizations, state organizations, national organizations, and other community related organizations.

OC Name:

AAPA Member #:

OC Email:

8. Student Academy Representative (REQUIRED POSITION)

SAR Name: *

AAPA Member #: *

SAR Email: *

Graduation date: *

SAR permanent email (this is NOT the SAR's secondary personal email, but would look like JMU-SAR@gmail.com or similar)

9. House of Delegates student representative

All interested students must apply for a spot on the student delegation. The application for the 2024 HOD student delegation is now closed. The application for the 2025 HOD student delegation will be open May 17, 2024 on this page: https://www.aapa.org/about/aapa-governance-leadership/student-academy/house-of-delegates-student-delegation/

10. Student Academy Representative Alternate (optional, but if filled, the student must be an AAPA student member):

SAR Alternate Name:

AAPA Member #:

SAR Alternate Email:

Graduation date:

11. Diversity Chair (REQUIRED POSITION)
The Diversity Chair serves as the liaison between the Student Academy and the student society regarding diversity issues affecting their classmates as future colleagues and health care providers. The elected individual need not be a minority, but must have a strong interest in supporting and promoting the education of students on issues of diversity.

Diversity Chair Name: *

AAPA Member #: *

SDCR Email: *

Graduation date: *

12. Green Chair (optional, , but if filled, the student must be an AAPA student member)
The Green Chair shall educate student society members on local and national "green" issues; work with campus and PA program leadership to facilitate green initiatives; increase interaction between the student society, constituent chapter, the Student Academy, and the AAPA national office with regard to green practice; maintain communication with the Regional Communications Committee or appropriate ad hoc committee chair regarding current green issues and ideas; inform the incoming class about the importance of professional involvement and AAPA membership; help maintain student society continuity from year to year by assisting the incoming class with the elections of officers.

GC Name:

AAPA Member #:

GC Email:

13. Health & Wellness Chair (optional, but if filled, the student must be an AAPA student member):
The Health & Wellness Chair will organize wellness events for the student society (for example- attending a group class, a running club, recipe sharing etc.), as well as promoting overall wellbeing of PA students while in school. This was a position created in 2015 by the Leadership Student Volunteer Group.

HWC Name:

HWC Member #:

HWC Email: