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CTAHPERD Student RepresentativeApplication Form 2007-2008 Send completed application by October 1, 2008 along with a letter of recommendation from a college/university professor. Connie Kapral CTAHPERD Executive Director 563 Miller Road South Windsor, CT 06074 Questions? ckapral©ctahperd.org Telephone & Fax: 860.644.9206 *Required Information I am interested in serving as: Student Representative Student Representative Elect Full Name: * College/University Attending: * Expected graduation date: * Major: * CTAHPERD Membership Number: * School Address: * School Telephone: * E-mail Address: * Home Address (include street, city, state, zip: * Home Telephone: * College/University Activities: Provide a brief (100 word) statement of interest Enter the Access Code:
Connie Kapral CTAHPERD Executive Director 563 Miller Road South Windsor, CT 06074 Questions? ckapral©ctahperd.org Telephone & Fax: 860.644.9206
