A Chapter of the American
Physical Therapy Association


 
 
 
 
Nomination Form for 2010 Elections
  Deadline to submit names to be printed on October 2010 ballot:
Friday, October 1, 2010.

You may nominate names from the Chapter Meeting floor after October 1.

The Nominating Committee will contact your nominee to assess their willingness to serve.

360-352-7298
PTWA, 208 Rogers St NW, Olympia, WA 98502
 

Nominee Name (Please submit one form per individual)


City


Position(s)

Your Name 


Your Phone Number and Email Address


Reason for Nominating this Person