2024 Write In Nominations - APTA Academy of Leadership and Innovation

2024 Write-In Nominations

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Thank you for your interest in a leadership position with APTA Academy of Leadership and Innovation. Please complete the form below to submit your nomination. Write-in nominations close on Thursday, July 13, 2023.

Read the job descriptions for each open position!

CANDIDATE INFORMATION & STATEMENT
First Name *		Last Name *
APTA Member ID: *
Address Line 1 *
Address Line 2
City *
State *		Zip/Postal Code *
Email Address *
Phone Number *
Check the box for each position you consent to be slated for. *You will only be slated for ONE position, chosen by the committee. By consenting, you agree that your consent and name may be published as a candidate for an HPA, GHSIG, or Tech SIG elected office. Duties of the above positions are described in the HPA: The Catalyst Section Bylaws and the HPA: The Catalyst Policies and Procedure Manual. It is expected that elected HPA leaders will not be restricted by their employment responsibilities from attending, and be willing to attend, HPA Board and Business meetings when required by their leadership roles. Most expenses incurred during travel for HPA meetings are reimbursed by HPA.	Academy of Leadership and Innovation Section Nominating Committee Academy of Leadership and Innovation Section Director of Operations Global Health SIG Programming Chair Global Health SIG Nominating Committee Tech SIG Nominating Committee PT Proud SIG Vice Chair PT Proud SIG Secretary PT Proud SIG Nominating Committee Chair
E-signature *
The following information is collected for the purpose of providing candidate details to HPA members prior to and during elections. All or portions of the information you provide below will be published in the summer issue of the HPA Resource and on the HPA website.
Current Professional Position (1-2 lines/sentences) *
Education (1-2 Lines/sentences on your credentials) *
Service Involvement *with APTA, its components or related organizations
Brief Biographical Statement (1-3 paragraphs about yourself) *
Candidate Statement (max of 250 words) *
Current Headshot *

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