Board of Directors Application

Board of Directors Application Form Wisconsin Director of Nursing Council - Education Forum, Inc.

Please submit your application by Jan. 5, 2018
First Name *
Last Name *
Designations (ie RN, BSN, MSN, DNS-CT, WCC) *
Name of Facility/Organization
Please List Title of Current Position
Please list Length of Time in Current Position
Preferred telephone numbers *
Email Address *
Are you a current member of WDONC?

Yes No
Member of WDONC since?
Please review the Board of Directors Responsibility Description.
I have read the Board of Directors Position Description, and, if selected, would agree to abide guidelines listed.

Yes No
Why do you wish to serve on the Wisconsin Director of Nursing Council Board of Directors? *
What will you contribute to the Board? *
What do you envision for Wisconsin Director of Nursing Council's future? *
Upload your Resume Here
Additional Information
Consider submitting letters of reference from Administrators or other leaders familiar with your Nursing Leadership knowledge to Melissa@WI-DON-Council.org. This is NOT a requirement but may be helfpul in dertermining strengths and support from administration to assume the volunteer position on the WDONC Board of Directors.
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Board of Directors Application Form Wisconsin Director of Nursing Council - Education Forum, Inc.