ATPE State Committee Service Information Form
 1. The ATPE state office must receive this form by July 11, 2014.

 2. If you have questions regarding the duties of any of these committees, please contact the ATPE state office by
     email at or by calling (800) 777-2873.

 3. If you know of ATPE members who might be interested in serving, please email them a link to this page.

Indicate your preferences by numbering the committees in the spaces below, with "1" being your top choice, OR click below


          Standing Committees                                                                         Other Committees
            Bylaws                                                                                    Educator of the year
            Leader Development                                                                              (Meets at Summit)
           Legislative                                                                               Leader of the Year
            Membership                                                                                          (Meets at Summit)
            Minority & Diverse Population Recruitment                              
            Public Information
        Home Address:                       
                                  Street address or P.O. Box                     
                                  City                                          State                                Zip
          Home Phone:  

              Cell Phone:  
            Home Email:

             Work Email:
                Region #:  

         Local Unit/SD:  

        Campus Name:

        Current Employment Position:


        Years of education experience:

        Age Range:              



       I pledge that if I am selected to serve on a committee, I will attend the meetings and be an active participant. I understand that submitting this form does not guarantee an assignment but that I will be considered for the committees I’ve selected.


       (It is not necessary to submit more than one information sheet per person)