IDENTIFICATION OF CANDIDATE
Name of Position applying for:
Current work organization or note if retired
Street Address Line 2
State / Province
Postal / Zip Code
email@example.com on record
How long have you been a member of ACNM?
What makes you uniquely qualified to for this position
Upload your CV (Resume)
I ACKNOWLDEGE: As an ACNM Volunteer or Liaison Representative, I will read and agree to the terms of the Leadership Guidelines of Ethical Conduct, Conflict of Interest Policy, Confidentiality Policy, Consent to Serve and Meet Volunteer Obligations, Copyright and Intellectual Property Policy, Anti-Discrimination and Harassment Policy, Racism and Racial Bias Position Statement, and Anti-Bullying and Incivility Position Statement as found on http://midwife.org/ACNM-Governance-Policies.
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