Submission Form for Chapter Awards

APTAMA Awards Nomination

Individual is being nominated for the following APTAMA Award:

Mary MacDonald

Research

Clinical Excellence

Rich Kessler Memorial Award

Name of applicant (please include all credentials):

Email of Applicant:

Current Employer:

Professional Education:

Clinical Experience:

APTA activities: include offices held, committee and task force membership

National:

Section:

Chapter:

District:

SIG or Committee:

Other professional memberships:

Name of Submitter

First Last

Email of Submitter(Required)

Personal References

Name of Reference 1

First Last

Email of Reference 1

Name of Reference 2

First Last

Email of Reference 2

Name of Reference 3

First Last

Email of Reference 3

Upload letters and CV here. We must have 3 letters and a CV to make this application complete. If you can upload a picture of the candidate as well, we would appreciate it.

Reference Letter 1

Max. file size: 300 MB.

Reference Letter 2

Max. file size: 300 MB.

Reference Letter 3

Max. file size: 300 MB.

CV of Applicant

Max. file size: 300 MB.

Picture of Applicant

Max. file size: 300 MB.

CAPTCHA

We inspire, engage and empower you to reach your potential.

Submission Form for Chapter Awards

APTAMA Awards Nomination

APTA activities: include offices held, committee and task force membership

Personal References

Upload letters and CV here. We must have 3 letters and a CV to make this application complete. If you can upload a picture of the candidate as well, we would appreciate it.

About Us

Continuing Education

Advocacy and Practice
For The Public
Careers & Advertising

My APTA MA

We inspire, engage and empower you to reach your potential.

Submission Form for Chapter Awards

APTAMA Awards Nomination

APTA activities: include offices held, committee and task force membership

Personal References

Upload letters and CV here. We must have 3 letters and a CV to make this application complete. If you can upload a picture of the candidate as well, we would appreciate it.

About Us

Continuing Education

Advocacy and PracticeFor The PublicCareers & Advertising

My APTA MA

Advocacy and Practice
For The Public
Careers & Advertising