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State & Federal Legislative Affairs Student Application



South Dakota Physical Therapy Association

Application for Funding from SDPTA for Legislative Activities (APTA House of Delegates Usher, Federal Advocacy Forum, State Government Affairs Forum)



  • Must meet one of the following criteria: 1) a current SPT/SPTA member of the APTA/SDAPTA and maintain membership throughout the fiscal year; 2) a resident of South Dakota; or 3) planning to practice as a PT/PTA in the state of South Dakota upon graduation.
  • Must be a current student during time that event is held.
  • Must attend a Spring or Fall Meeting following the event and give a verbal report to membership.



  1. Provide responses to the questions below and save in a word or PDF document. 
  2. Email your completed document to the current President ( and Chief Delegate of the SDPTA ( in the Board Members section of the SDPTA Web Site). SDPTA Board Members will likely be involved in the selection process if there are more applications than allotted funded positions. The SDPTA Board will fund up to two students during any one fiscal year (January – December).
  3. If attendance at the event you are requesting funding for requires you to miss class time, please attach email confirmation from your program director/faculty member stating you have permission to miss class for this event.
  4. The application deadline is January 15 of the given year of the event. Students who apply for the APTA House of Delegates Usher will have to complete another application process through the APTA. 

The SDPTA has budgeted monies for these events.  In the event that the APTA House of Delegates occurs at the same time as the Federal Advocacy Forum, the student participants would be eligible and expected to attend both events. Due to the small number of annual funded positions offered, first time applicants or re-applicants who weren’t funded the first time will be considered prior to those that received funding for these positions in the past. 

If accepted for funding for one of these positions, the student will work with assigned Board Member or administrator regarding the process to secure transportation and lodging for the event. The SDPTA will reimburse travel (ie flight, transportation from airport to/from hotel) and lodging for the event. The student will be responsible for his/her own meals. The student may be required to pay up front on his/her own and get reimbursed after the completed event. Copies of all receipts must be kept for reimbursement and submitted to the SDPTA Treasurer. The SDPTA Treasurer will distribute the monies after the event. For some of the events (i.e., APTA HOD Usher) there likely will be the opportunity to room with other students. 



1. Full Name:


2. Email Address: 

3. APTA Membership Number: 

4. Name of PT or PTA program you attend and expected date of graduation: 

5. Event you wish to attend with funds requested from the SDPTA for the following Legislative Activities:  HOD Usher, Federal Advocacy Forum, or State Government Affairs Forum.

6. In a brief statement (no more than 2 typed, double-spaced pages), please address the following topics:  A) Briefly explain your past participation in city, state, or national political activities; B) Briefly explain why you would be a good candidate for this opportunity; C) Describe how you will utilize this opportunity to benefit the SDPTA; D) Describe how you plan to contribute to the profession of physical therapy legislatively in the next 3-5 years; and E) Describe how this event will contribute to your professional development as a future PT or PTA.

7. Please provide list of activities you have participated in during the last 3-5 years. Include leadership positions, offices held, and participation on committees. Also include any community service opportunities.

8. Please include the following statement at the end of your application, as well as your electronic signature and date of application.


I understand that this application and all documents submitted become the property of the South Dakota Physical Therapy Association (SDPTA). 

Signature of Applicant:

Date of Application:

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