ANA-NY Ballot Nomination Form
Nominations must be submitted by Friday, May 2, 2025
I wish to nominate (and/or) be nominated for the Office of:
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First Name
Last Name
Position
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Please Select
Vice President and ANA Membership Assembly Alternate to the President
Secretary
Director-at-Large
Nominations and Elections Committee Member
ANA Membership Assembly Representative
Credentials
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Nominator Email
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example@example.com
Nominee Email
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example@example.com
Present Employment/Position
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ANA-NY Service
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Experience Serving on a Board
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Position Statement (100 words or less. May upload separately below)
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Upload Position Statement
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