PA Foundation Board of Trustees
2024 Call for Nominations

The PA Foundation Committee on Nominations is seeking individuals to serve as members of the Board of Trustees. The incoming board members selected through this nominations cycle will serve a term beginning July 1, 2024, and ending June 30, 2027.

Please review the 2024 Nominee Information Guide before completing the application below.

Please confirm you have read and acknowledge the requirements of trustee service as outlined in the 2024 Nominee Information Guide. *

Yes, I have read and acknowledge the requirements.

Nominee Information

First Name *

Middle Initial:

Last Name *

Home Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Employer Name: *

Your Title: *

Employer Address *

Address Line 2

City *

State *

Zip Code *

Work Phone Number *

Work Email Address *

Preferred method of contact: *

Home

Work

Background/Qualifications

Are you a PA? *

Yes

No

Please list your profession: *

Practice setting:

Specialty:

Number of years in practice:

Number of years in this profession:

AAPA Member ID, if applicable (note: PA nominees must be AAPA Fellow member in good standing):

Please select the areas in which you have experience and relationships (check all that apply): *

Health equity and DEI programmatic funding

Corporate foundations (e.g. pharma, insurers, biotechnology, other healthcare industry partners)

Private foundations

State or regional funders

Other Other

Please describe your background/experience and relationships in the areas selected above. *

Please list non-profit boards and committees that you serve on or have served on (business, civic, community, fraternal, political, professional, recreational, religious, social).

	Organization Name	Role/Title	Dates of Service
1.	Organization Name	Role/Title	Dates of Service
2.	Organization Name	Role/Title	Dates of Service
3.	Organization Name	Role/Title	Dates of Service
4.	Organization Name	Role/Title	Dates of Service

Free Responses

1. Please briefly describe your professional background and other relevant experience. *

2. Please explain what motivates you to apply for a volunteer position with the PA Foundation Board of Trustees. *

3. Please briefly outline the specific skills you bring, or contributions you hope to make, to the PA Foundation Board. *

4. The PA Foundation's mission is to empower PAs to improve health through philanthropy and service. Briefly explain what this mission means to you. *

File Uploads

Résumé/curriculum vitae: *

Thank you for your interest in serving your Foundation!