Student Representative Application

Future ProfessionalsStudent Representative Application

Executive Council

CTAHPERD Student Representative Application Form 2012-2013

Send completed application by July 1, 2012 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

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 *

Street *

City *

State *

Zip *

Home Telephone *

College/University Activities: Provide a brief (100) statement of interest *

Type the characters you see in the picture below

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Issues & Legislation

The AAHPERD Legislative Action Center provides you with the information and resources you need to address the health, physical activity, dance, and sport issues being debated on Capitol Hill.

CTAHPERD Connecticut Association of Health, Physical Education, Recreation and Dance -

Executive Council

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Issues & Legislation