2027 House of Delegates Nomination Form

Individuals wishing to become Delegates to the APTA House of Delegates submit their own Nomination Forms. The completed form must be RECEIVED in Chapter Office by March 15, 2026 at 5:00 p.m. There will be no exceptions to this deadline.

Qualifications: Only physical therapy and physical therapy assistant members who are in good standing at the time of the HOD may serve as Chapter delegates.

Please Note: Physical Therapy Assistant's are eligible to go to House of Delegate's.










Please list specific Chapter, District, Section or National Association activities in which you have been involved. Include ONLY: offices held, committee or task force appointments, other appointed positions, delegate to DA or HOD. Please include dates and be specific. The information you provide is used by the Delegate Assembly to evaluate candidates.
IF ELECTED, I WILL ATTEND DISTRICT MEETINGS WHOSE PRIMARY PURPOSE IS TO DISCUSS ISSUES RELATIVE TO THE DELEGATE ASSEMBLY OR HOUSE OF DELEGATES MEETINGS.



IF ELECTED, I WILL ATTEND THE DELEGATE ASSEMBLY HELD PRIOR TO THE HOUSE OF DELEGATES MEETING FOR WHICH I AM ELECTED.


 

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