2024 Hawai'i-ANA Consent to Serve and Self-Nomination Form

CONSENT TO SERVE and SELF-NOMINATION

2024 Elections
I am interested in active participation in the Hawai'i - American Nurses Association as a candidate for the following open elective office (choose one):
For more information about these open positions please refer to:

Hawaiʻi-ANA 2024 Candidate Positions, Roles, and Responsibilities

For your reference, Hawai'i-ANA Bylaws Adopted 2023 .pdf
Full Name

First NameLast Name
Credentials
I am a Hawai'i-ANA Member

Other
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number

Area CodePhone Number
I certify that the above information is accurate. I hereby submit my consent to serve, should I be elected to the position for which I have indicated interest.
Date
Signature (electronic is fine)
Optional Information
Position Statement: Briefly state your rationale for running for the position you have indicated above. You may include your personal views on nursing and current issues including, if elected, what your major contribution(s) would be to Hawai’i–ANA and in particular to the position you have indicated above. You may want to include past offices, committees, association membership, nonprofit work, etc. (This will be shared with Hawai'i-ANA members who will vote in this election.)
Upload your bio, resume or CV. (This will not be shared beyond the Nominating Committee.)

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CONSENT TO SERVE and SELF-NOMINATION