Delegate Application Form

Each year, just before Annual Conference, several hundred delegates representing each state gather to conduct the annual business meeting of ENA. It is an exciting and educational experience. Proposals that have been crafted throughout the year are presented, the new leaders are introduced, and you have the opportunity to meet emergency nurses from across the United States and the world. If you have never been a delegate, it is a wonderful experience. You can look forward to debates, consulting with your fellow state delegates and literally shaping the direction of our national organization.

What does it take to become a delegate? It takes participation in ENA and emergency nursing. You must be an active member to be a delegate. Our standard procedures permit the President, President-Elect, Secretary, Treasurer, Immediate Past President and Council Chairs to represent WA-ENA. The rest of the delegates come from the membership of WA-ENA. To represent the Washington State members, you must apply and meet certain criteria. The criteria set forth in the application documents your participation at the state level and assures WA-ENA members that the delegates selected are familiar with both national and Washington State emergency nursing issues. Take an active role in your ENA and make a great memory at the same time.

All delegates must attend the August State Council meeting to prepare for the business of General Assembly. There are no exceptions to this.

By filling out the application, you are agreeing to attend the August State Council meeting and all sessions of the General Assembly if selected as a delegate.

I have read the above. I agree to attend the August State Council meeting and the entirety of the General Assembly, or I will be asked to return any money given to me for attending the General Assembly as a delegate.

Full Name

First NameLast Name

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile No. :

Area CodePhone Number

E-mail :

Where the confirmation will be send to

ENA Member Number

Shirt size :

Many years Washington ENA provides a shirt to delegates to be worn as a team representing the state of Washington at General Assembly. Please specify a shift size and shirt style (male/female). If our budget allows for a shirt, we will order one in your specified size.

Gender:

Size:

Washington State Council meetings attended from August 2025 through April 2026. A minimum of one during this period is required.

Check date(s) attended:

I am a current (select all that apply):

Published in a healthcare-related professional journal August 2025 to April 2026:

List publication title, article title:

Do you have another article published in a professional journal to list?

List publication title, article title:

Published article in professional nursing publication August 2025 to April 2026:

List publication title, article title:

Do you have another article published in a professional nursing publication to list?

List publication title, article title:

Participated in activities supporting Emergency Nursing (i.e. injury prevention events, legislative activities, speaking at non ENA event about ENA initiatives, presenting at a school of nursing for ENA, committees, authors a resolution, etc.):

Please describe your activity:

Do you have another activity supporting Emergency Nursing to list?

Please describe your activity:

Present a "Critical Topics in Emergency Nursing" at a Washington ENA State Council meeting:

Present on an issue brought to a State Council meeting for consideration:

List date of meeting and topic of the issue:

Do you have another issue brought to a State Council meeting for consideration to list?

List date of meeting and topic of the issue:

Serves on a National ENA Committee:

List committee:

See ena.org/membership/get-involved/volunteer-opportunities for list of national committees

Note that the points calculated here may not be your final awarded points. Applications are reviewed by the Membership Committee and checked for accuracy. If you have not provided sufficient supporting evidence for an activity, or it is found that a question has been answered inaccurately points will be deducted from the total.

Your calculated points:

By signing in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Selections will be made and delegates notified prior to July 7, 2026.

Signature

Delegate Application Form

I. Demographics:

II. Criteria:

VIII. Applicant's E-Signature