Wufoo

(Individual who will serve in place of the elected Governing Councilor with full rights to vote and speak. *Must be an APHA member in good standing, who is not an elected Governing Councilor)

(Individual with authority to approve appointment of a proxy to the Governing Council. * See below for more details on who is authorized to appoint proxies)

Please check and indicate your name and date

Affiliated Association: The Affiliate President may select a proxy for its representative or for a vacant seat that represents the Affiliate, in accordance with its own procedures. If the President is unavailable, the authority to select a proxy shall shift to the Affiliate Representative to the Governing Council, Affiliate President-elect, or the Affiliate Immediate Past President in that order. APHA members who are not voting members of the Governing Council shall be eligible to hold the proxy.

Executive Board: An Executive Board member may select any member of APHA as a proxy in Governing Council provided that the member is not already a voting member of the Council.

Section: The Section Chair may select a proxy from the Section that the elected Councilor or vacant seat represents. If the Chair is unavailable, the authority to select a proxy shall shift to the elected Councilor who will be absent, Section Chair-elect, or the Section Immediate Past Chair in that order. Section members who are not voting members of the Governing Council shall be eligible to hold the proxy.

Special Primary Interest Group: The SPIG Chair may select a proxy from the SPIG that the elected Councilor or vacant seat represents. If the Chair is unavailable, the authority to select a proxy shall shift to the elected Councilor who will be absent, SPIG Chair-elect, or the SPIG Immediate Past Chair in that order. SPIG members who are not voting members of the Governing Council shall be eligible to hold the proxy.

Student Assembly: The Chair of the Student Assembly may select a proxy for its representative or for a vacant seat that represents it. If the Chair is unavailable, the authority to select a proxy shall shift to the Governing Councilor who will be absent, Student Assembly Chair-elect, or Immediate Past Chair in that order. Student Assembly members who are not voting members of the Governing Council shall be eligible to hold the proxy.