Submission Form: Zelia Celona PTA Award

Please complete the following application and submit a letter.  The letters should describethe candidate's engagement in the profession and professional advancement along with examples of compassion for peers and patients.   

Please submit these letters to 

This award will be presented at the Annual Meeting 

(* Denotes Required Fields)

Nominee Information

Name of Nominee
Nominee's current employer
Name and contact of person submitting
Please list 2 references and email contact. The committee may choose to follow up with these references.
Reference 1 Name and contact
Reference 2 Name and Contact

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RIAPTA Liberty Square Group
4 Liberty Sq, #500
Boston, MA 02109
(857) 702 – 9915