CAPA PA of the Year Award

This award recognizes the PA’s contributions to the profession in the clinical setting and community. Recipient must be a CAPA member. Selection for this award will be based on the following criteria:

• Service to the PA profession

• Inspiration to colleagues and patients

• High quality patient care

• Professional leadership

• Community and volunteer contributions, humanitarian efforts

Nominator Name *

Nominator Email *

Nominee Name *

Nominee City *

Nominee Specialty *

Nominee Email Address *

Nominee Phone Number

Recommendation - Please attach a letter of recommendation that describes why the PA nominated is deserving of this award. *

Supporting Documents - Please attach any other supporting materials (CV, articles, additional letters of recommendation, etc.) that would help the Awards committee in

I confirm that the Nominee is a CAPA member. *

Yes

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