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2022-23 AAPA BOD & Volunteer Disclosure & Conflict of Interest Form
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here
before completing this form.
Name and Volunteer Information
Please enter your name and contact information for AAPA records.
First Name
*
Last Name
*
AAPA ID
*
🛈
Email address
*
State/ U.S. Territory
*
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
APO/FPO/Foreign Service
Are you a member of the 2022-23 AAPA Board of Directors (BOD) or a board candidate?
*
Yes
No
What is your position on the AAPA Board of Directors?
*
President
President-elect
Immediate Past President
Secretary-Treasurer
Vice President/ Speaker of the House
Director/ 1st Vice Speaker
Director/ 2nd Vice Speaker
Director-at-Large
Student Director
Candidate