Public Member Board Position

IDENTIFICATION OF CANDIDATE FOR PUBLIC MEMBER BOARD POSITION

ACNM seeks a Public member to join our board of directors (BOD), that will make an effective, and unique, contribution to the board's work and the organization's governance. The public member will be a representative of the consumers of services provided by certified midwives and certified nurse-midwives, and will serve as a voting member on the BOD with all rights and privileges, including holding office and serving on committees."

The public member will offer unique value by:

Enhancing the board’s credibility with the public
Making the board more accountable to the public
Bringing a different perspective and new ideas to the board’s deliberations and its priorities

Applying for: *

Public Member of the ACNM Board of Directors
Term May 2021 -- May 2022

Name

First Name Last Name

Credential(s):

Current work, organization, or note if retired:

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email

example@example.com

1) Describe your experience as a consumer of midwifery.

2) What skills would you bring to the ACNM Board?

3) Has there ever been a finding or probable cause or other citation issued against you for a breach of ethics or unprofessional conduct by an administrative agency or other professional group?

Upload your CV.

Please supply the names and contact information for three references.