Board and Leadership Application Board and Leadership Application Name First Last Email Board and Leadership Positions* Treasurer (Board Position) Community Engagement Education Committee Federal Affairs Liaison Finance Committee Government Relations Committee Membership Committee Nominating Committee Practice Committee Reimbursement Committee Please select all that you are interested in:Professional Education (school, degree, year):*Present and Past Employment (title, facility, years):*APTA /APTADC InvolvementPlease list any activities you have participated in at the Chapter or National levelPersonal Statement*This may include why you are seeking this position, your qualifications and ability to serve APTADC, your opinion about the philosophy and current priorities of the Chapter etc.
