State Office Application

ANSA Board of Directors' Application

Postion

Personal Information
Name
Address
City
State
Zip
Phone
EMail

School Information
School of Nursing
Address
City
State
Zip
Year in School [?]
Graduation Date [?]

Briefly describe any experience you have that would be beneficial in the office you are seeking. Include offices held in your local SNA, other campus or community organizations, and any relevant work experience.

List previous awards and accomplishments.

Briefly explain why you are interested in serving on the ANSA Board of Directors.

Biography
This needs to be a brief letter including information about yourself, your goals as an officer, and anything else you want to convey to your readers. If you win the position, the following will be posted on the ANSA web site in your bio page.

For STAT Editor/Web Master Only
List your experience relevant to editing a periodical. Include software you are familiar with such as Microsoft Publisher, Adobe Photoshop, and Acrobat Professional pdf editor (include skill level: beginner, moderate, advanced). List your experience relevant to managing a web page. Include languages you are familiar with such as HTML, PHP, and Macromedia Flash (include skill level: beginner, moderate, advanced). List any other information you feel may qualify you for this position.

NOTE: It is not a requirement to be highly skilled with the above mentioned software and programming languages.

ALL CANDIDATES:
All members of the ANSA Board of Directors will be required to complete ANSA’s Statement of Understanding upon election to office. This form requires the signature of the dean or director of your nursing program’s signature (see form). This form must be placed on file with the ANSA Treasurer by the December meeting of the Board of Directors. Failure to file this form with the Treasurer will result in the withholding of expense reimbursement until the form is on file. ANSA will not resume responsibility for the expenses incurred by candidates or new board members for attendance at the 2006 ANSA Convention.

All newly elected Board of Directors members will be required to attend a joint Board of Directors meeting on Friday afternoon. At that time, outgoing and incoming officers will exchange files and provide other necessary information and advice.

I have read and understand this application for office and agree that if elected I will be required to complete the ANSA Statement of Understanding. I understand that I will be required to attend a Friday afternoon meeting on October 13th for new officers. I have read the ANSA Bylaws that pertain to the Board of Directors position that I am seeking I understand that my application for office will be rejected if incomplete. If elected to office, I will faithfully fulfill the duties of my office to the best of my abilities. I verify that I am a student in good standing with my school/college/university.

(This form will be printed and ready for your signature at the convention.)

I AGREE. I have read and agree with all of the above.

Enter Verification Code Here: (case sensitive)