2022-2023 Consent to Serve

2022-2023 Consent to Serve

Rhode Island State Nurses Association 2022 Elections
I am interested in active participation in the Rhode Island State Nurses Association
Name (do not abbreviate)

First NameLast Name
Credentials
Position
Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Membership #
Professional Activity
Position Statement: Briefly state your personal views on nursing and current issues including, if elected, what your major contributions(s) would be to RISNA and in particular what are your qualifications for this position? This statement will be used in a Candidate Biographraphy sent with the ballot.
Position Statement
****MUST BE A MEMBER OF RISNA FOR A MINIMUM OF 1 YEAR***

ALL NOMINEES MUST BE INTERVIEWED BY THE NOMINATING COMMITTEE. THE COMMITTEE WILL PRESENT A SLATE TO THE RISNA BOARD OF DIRECTORS FOR APPROVAL PRIOR TO DISTRIBUTING THE BALLOT.
Please return completed form by December 5, 2022
Should be Empty: