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Recommendation for Academy Office Form - 2026 Pediatrics

The Nominating Committee annually seeks recommendations for nominees for open, elected positions on the Board of Directors and Nominating Committee.

All APTA Pediatrics members may make recommendations or self-nominate for office by submitting a Recommendation for Academy Office Form. The deadline for submitting forms for the 2026 elections is March 31.

You can submit up to 3 nominations on this form. For additional nominations beyond 3, please complete another form. Thank you.

*1.Nominator's Contact Information (person completing this form)(Required.)

Name

Email

Phone

(Primary) State

*2.Who are you nominating?(Required.)

Myself

Someone else

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