Dallas Fort Worth Chapter
Chapter Board Member Nomination Form 2022
The DFW ANIA Chapter has several positions opening up at the end of the year. If you'd like to serve, please submit your information, or nominate one of your colleagues.
Name of Nominee
*
First Name
Last Name
Nominated by:
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Enter Myself or Name of Nominator
Email Address
*
example@example.com
Employer Name
*
Phone Number
Professional licensure
Memberships to professional organizations
Are you an ANIA Member?
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Yes
No
Are you Nursing Informatics Board Certified?
Yes
No
Select all possible board positions that you might be interested in:
Vice President (Voting member)
Treasurer (Voting member)
Communications (Service position)
Event Planning (Service position)
Chapter Meetings / Webex Planning (Service positions)
Website Management (Service position)
Enrollment/Recruitment (Service position)
Describe your current job role
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Describe your informatics experience that has prepared you to be a Board member for DFW ANIA
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Discuss your involvement in the DFW ANIA Chapter
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Why do you wish to participate on the DFW ANIA Board?
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What do you feel you can contribute to the organization?
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Additional comments or experience that you would like the Board to consider
*
Upload Resume
*
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