Board and Leadership Application Board and Leadership Application Name First Last Email Board and Leadership Positions*Treasurer (Board Position)Community EngagementEducation CommitteeFederal Affairs LiaisonFinance CommitteeGovernment Relations CommitteeMembership CommitteeNominating CommitteePractice CommitteeReimbursement CommitteePlease 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.
