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> APTA Washington Award Nomination Form
APTA Washington Award Nomination Form
Who would you like to nominate for an Award?
Your nominee's name
Your nominee's email address
Your nominee's phone number
Choose an Award
To be eligible, nominees must be PTWA members (except for Joseph Black Friend of PT Award).
To reread the criteria, visit:
http://aptawa.org/misc/PTWA-awards-criteria
Award for Clinical Excellence
Physical Therapist of the Year
Physical Therapist Assistant of the Year
Donna El-Din Distinguished Service Award
Joseph Black Friend of Physical Therapy
Why are you nominating this person?
Award for Clinical Excellence nominees also require that you submit a CV. Please email the CV to erica@aptawa
.org
.
Please fill out the information below so that we may contact you with any questions.
Contact Information
First Name
Last Name
Work Phone
Home Phone
Email
Thank you for submitting an award nomination. All fields are required to submit this form. If you have questions about submitting a nomination, please contact nominating
@aptawa.org
.
Submit