- Please note that to be eligible you must be a full financial individual member of AAPM
- All fields with a red line are mandatory
- Use the upload buttons to submit your two referee statements
- Use the upload button to submit your profile photo
- Larger files (1MB or more) will take a few minutes to upload
- Enter all other details directly into the form
- If the form is correctly completed, you will be redirected to an acknowledgement page and also receive a confirmation email
- If you are not redirected (allowing sufficient time for documents to upload), this means there is an error in the form
Please Note: You will NOT be able to save a partially completed form, so you will need to have all the information ready before applying. It is also advisable to make sure you have all your information saved to a text or Word document and retain a copy for your records. That way, if there are any problems in submitting the form, you do not lose the content and can re-enter it.
Please respond to each individual selection criterion below.
As a guideline, each response should be approximately 150-250 words.
Provide evidence or examples for the following areas of Practice Management:
AAPM and AGPAL QIP use photographs of State and National winners of the Practice Manager of the Year Award in reports and award promotion. Please read the following statement and tick the box below to indicate your permission for this, should you be one of those winners.
I grant to AAPM and AGPAL QIP the right to take photographs of me in connection with the Practice Manager of the Year Award. I also agree that AAPM and AGPAL QIP may use these photographs of me in print and/or electronically for such purposes as publicity, illustration, advertising, and Web content.
I authorise APM and AGPAL QIP the right to use the profile photograph of me that I have provided in connection with the Practice Manager of the Year Award. I also agree that AAPM and AGPAL QIP may use this photographs of me in print and/or electronically for such purposes as publicity, illustration, advertising, and Web content.
The winners of the State AAPM Practice Manager of the Year awards will be required to partipate in a five minutes Q&A session after the presentation at the Practice Manager Symposium (formerly Practice Manager Education Day). The National will be required to participate in a five minutes Q&A session after the presentation at the National Conference.