Candidate Profile/Consent Section |
| Nominee: |
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| Home Address: |
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| Business Address: |
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| Home Phone: |
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Business Phone: |
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Educational Background:
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(Include Advanced Clinical Competencies) |
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Professional Experience: |
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| Experience related to the Association
(State, Section, National): |
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Candidate Response Section: |
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Please take a few moments to respond to the following two questions.
Limit your response to 200 words or less. The candidate response
questions following will appear in the summer newsletter. |
| Question #1: What
do you see as the major issue(s) facing the Maine Chapter of the
APTA? |
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| Question #2: What goals might address
these issues? |
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You must be a Maine Chapter APTA member to nominate a collegue or yourself,
please provide your membership number:
All nominations are confidential. The Nominating Committee
will contact the individual and discuss the position and obtain their
consent.