CONSENT TO SERVE
ANA-RI 2016 ELECTIONS
I am interested in active participation in the ANA-Rhode Island
President-Elect
Secretary
Treasurer
Board of Directors
Alternate Membership Assembly
Name
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First Name
Last Name
Credentials as you wish them to appear in Candidate Biography:
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Membership Number
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Current Position
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Employer
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone #
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Work Phone #
E-mail
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Professional Activity
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Position Statement: Briefly state your personal views on nursing and current issues including, if elected, what your major contribution(s) would be to ANA-RI and in particular to the position which you seek. This statement will be used in the Candidate Biography sent with the ballot.
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Consent to Serve deadline:
September 9, 2016
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