National Office Request to Run for 2021-22 Board and NEC

Request for Application and Information

to run for 2021-22 Board of Directors and Nominating and Elections Committee
Please complete this form to request a packet of information on running for the NSNA Board of Directors and the Nominating and Elections Committee. (Red Stars indicate required fields)

Pre - Slate Deadline is February 19, 2021 5:00 pm EST
Choose one *

Mr. Ms.
Full Name *

First Name Middle (optional) Last Name
Address *
City *
State *
Zip *
Cell Phone *
(or Primary Phone)
Home Phone
(Optional)
Email *

Confirmation Email Click here then click "Sub Label" above to change this text
NSNA Membership Number *
Expiration Date *

Month Day Year
School Attending *
Include School Name, City and State
Type of Program

Associate Diploma Baccalaureate RN to BSN Other
Office of Interest
Optional. You can decide later.
Expected Graduation Date *
Expected Grad Date
Election Area

North South East West Don't know
Questons or Comments
Where did you hear about running for the NSNA Board of Directors and the Nominating and Elections Committee?

Facebook Faculty Imprint Instagram NSNA Broadcast Email NSNA Member Nominating and Elections Committee member
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Request for Application and Information