CRN Elections

Nominations Form
Complete the form below and submit online by September 19, 2022.
Direct any questions to Karen Greathouse or your Region Representative.

Review Position Descriptions & Requirements.
Select the position you are interested in:*

Chair-electRegion II RepresentativeRegion II Alternate RepresentativeRegion IV RepresentativeRegion IV Alternate Representative
Full Name*

First NameLast Name
Credentials and certifications (RD, LD, etc.)*
E-mail*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Phone:

Area CodePhone Number
Home Phone:

Area CodePhone Number
I. Current Employment/Position: Present position, job title, institution and years of employment (if you supervise any individuals, please explain):
II. Education:
III. Leadership positions held in professional societies (i.e., Local CRN Chapter, ADA, etc.):
IV. What related experience and skills have you obtained to prepare you to be a CRN leader?
V. What do you perceive as an important issue impacting renal nutrition today?
VI. In 100 words or less, state your goal for office, if elected:
Note: This statement will be published with the elections ballot.
Please upload your letter of recommendation here:*
Commitment: The CRN Executive Committee holds quarterly conference calls, and meets in person each spring at the NKF Spring Clinical Meetings.
I agree to attend the Executive Committee meetings and conference calls held each year.*

I agree
Should be Empty:

Nominations Form