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Nomination of Officers

2007 elections will take place at the Fall Chapter Meeting. We have the following vacancies:

  • President ( 2 year term)
  • Treasurer
  • Delegate
  • PTA Representative
  • District 2 Chairperson (one -year term)
  • District 3 Chairperson
  • District 4 Chairperson
  • Nominating committee member

 

You may nominate a colleague or yourself for any of these positions by:

  1. Completing the form below
  2. Contacting the chair of the Nominating Committee:


    email:

  3. Printing the nomination form and sending to the Nominating Committee Chair (address: )
  4. Link to a printable version of the nomination form

Nomination Form:

Candidate Profile/Consent Section

Nominee:
Home Address:
Business Address:
Home Phone: Business Phone:

Educational Background:


(Include Advanced Clinical Competencies)

Professional Experience:

Experience related to the Association (State, Section, National):

Candidate Response Section:

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?

Question #2: What goals might address these issues?

Position:

You must be a Maine Chapter APTA member to nominate a collegue or yourself, please provide your membership number:

I grant permission for my name to be placed in nomination for an office in the Maine Chapter of the APTA. I agree to serve if elected.

All nominations are confidential. The Nominating Committee will contact the individual and discuss the position and obtain their consent.

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Maine Chapter American Physical Therapy Association
PO Box 1783
Portland, Maine 04104
Phone/Fax (207) 799-1584
president@meapta.org
Copyright © 2005 Maine Chapter of the American Physical Therapy Association
All Rights Reserved