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EO Application/Nomination Form

The Search Committee for the Executive Officer position at the American Association of Physics Teachers is seeking nominations/applications for the position.

The Search Committee will begin review of the applications on October 1, 2005.

* - Required Fields

 
1. Nominee/Applicant Contact Information

Name of Nominee/Applicant*:


Institutional Affiliation*:


Institution Address:


Home Address:


Work Phone:


Home Phone:


Fax Phone:


E-mail:


2. Nominee/Applicant Experience & Activities

Please complete the Educational Experience, Professional Experience and Activities information areas:
    Educational Experience (list institution, degree, and year received):


    Professional Experience:


    AAPT and Other Physics Activites:
3. Nominator Information (if not self-nominating)

    Nominator (Name and Address):


    Daytime Phone:


    Has individual agreed to be nominated?

      Yes
      No

    Please include supporting statement for the nominated individual:

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