2025 ANA-Maine Consent to Serve Form

ANA-MAINE is seeking members of the association who would be willing to serve on the Board of Directors. Open positions are: President-Elect (3-year term prior to 3-year President term), Treasurer (2-year term), and two Director seats (2-year terms). The graduate and undergraduate student representative positions (1-year term) are also open. We are seeking volunteers who are committed to our profession and desire to represent Nursing and share the voice of many. Elections will be held in September.

Initial completion of the “consent to serve” will be followed up with a screening interview and assessment of your specific interests and availability, and an opportunity to clarify responsibilities of the position. Nurses on the ANA-MAINE Board of Directors have a pulse on Maine nursing. They can, and do, influence nursing practice and the health of the people of our state.

Come join us!!

Board position, Commission, or Committee in which you are interested Open board positions include President-Elect, Treasurer, and two Director seats, Graduate Student Representative, and Undergraduate Student Representative

Position

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

Phone Number

Area CodePhone Number

Workplace or College*

Work or College Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work or College E-mail

Work or College Phone Number

Area CodePhone Number

Work Title/Position

Credentials

Years in Practice

Field of Nursing

Professional Activity

Position Statement: Briefly state your personal views on nursing and current issues including, if elected, what your major contribution(s) would be to ANA-MAINE and in particular what are your qualifications for this position. This statement will be used in a Candidate Biography sent with the ballot.

I certify that the above information is accurate. I hereby commit my intention to serve, should I be elected or appointed to any of the posts for which I have indicated interest.

Please complete this form by September 1, 2025.

Signature

Date

Thank you for your interest in ANA-MAINE!

ANA-MAINE Consent to Serve Form