2024 QLD Branch Awards - Nomination Form

Recognise a great APA Physiotherapist

All nominators and candidates must be financial members of the Australian Physiotherapy Association. For the selection criteria, terms and conditions, please click here

All nominations must be received by 5:00pm Monday 30 September 2024

Question Title

* 1. Your details

Nominators name

Nominators phone number

Nominators email address

Question Title

* 2. Name of member you wish to nominate

Question Title

* 3. Please indicate which category you wish to
nominate this person for (select one category only)

Contribution to the profession: An award presented to an APA member who has made an outstanding contribution to the physiotherapy profession and the Association.

Contribution to the APA by a Recent Graduate (5 years or less since graduation): A recently graduated physiotherapist (5 years or less), who has given prominent contributions to the profession and the APA, will be the recipient of this award.

Contribution to an APA Regional or National Group: This award recognises the tireless efforts of members of any APA regional or national group across NSW. The recipient will have provided outstanding contributions to their group.

Contribution to Aboriginal and/or Torres Strait Islander Health within the Physiotherapy Profession: Presented to an APA member who has made an outstanding contribution to Aboriginal and/or Torres Strait Islander Health. Nominees can be working in research, education or clinical setting. Nominations for this category will be accepted from members of the community as well as physiotherapists who wish to nominate colleagues.

Contribution to Research: Presented to an APA member who has made an outstanding contribution to physiotherapy research that benefits the public and/or professional community.

2024 QLD Branch Awards - Nomination Form

Recognise a great APA Physiotherapist

Question Title

* 1. Your details

Question Title

* 2. Name of member you wish to nominate

Question Title

* 3. Please indicate which category you wish tonominate this person for (select one category only)

* 3. Please indicate which category you wish to
nominate this person for (select one category only)