Nominations Application and Consent to Serve

Nominations are being accepted to fill four (4) open Member at Large positions and one (1) President-Elect on the ACNA Board of Directors. Terms for these BOD positions will be two years, beginning January 1, 2021 through December 31, 2022 and President Elect will be four (4) years (one year president elect, two years as president and one past president).

Regular and Retired members of ACNA in good standing who have been members for a minimum of one (1) year at the time of application and have participated on at least one (1) other ACNA Committee are eligible to run for Board of Director positions.

Please complete the information below and submit. To complete the nomination process,  submit your CV and photo (headshot) to info@cannabisnurses.org

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* 1. Candidate Information:

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* 2. Candidate's Campaign Statement (500 words, including your career, committee service (for ACNA or other organizations), leadership background and your vision for the organization):

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* 3. President Elect Candidate ONLY please review the following Bylaws requirement and write a 500 word reflection on what that means to your leadership:

President-Elect must be a member for a minimum of two (2) years and contribute substantial service to the organization (e.g. active committee work, volunteering for tabling events, service at ACNA conference, mentoring to members) through volunteer work and/or service with related nursing or non-profit organizations and/or state or national advocacy work.  Demonstrates the ability to utilize communication skills and act with diplomacy.  Strong interpersonal skills are a must.

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* 4. How long have you been practicing as a nurse?

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* 5. Please upload your CV. Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 6. Please upload a high resolution headshot of yourself. PNG, JPG, or JPEG only.

JPEG, JPG, PNG file types only.
Choose File

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* 7. What is your highest level of education? 

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* 8. In which healthcare environment do you currently work? (Select all that apply)

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* 9. I consent to have my name and photo made public on the ACNA website.

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* 10. I have reviewed the ACNA 2020 Bylaws

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* 11. I have reviewed the ACNA Conflict of Interest Policy

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* 12. If elected, I agree to service ACNA with dedication and timeliness. I understand that I will be asked to contribute in any capacity as needed or appointed by the President of ACNA.

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* 13. Optional - Have you ever served in any branch of the United States military, or not?

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* 14. Optional - Demographics - Gender
Please check all that apply

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* 15. Optional - Demographics - Pronouns

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* 16. Optional - Demographics - Age Group

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* 17. Optional - Demographics - Race/Ethnicity (Fernandez, T., Godwin, A., Doyle, J., Verdin, D., & Boone, H. 2016)
Please check all that apply

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* 18. Optional - Demographics - Disability/Ability (Fernandez, T., Godwin, A., Doyle, J., Verdin, D., & Boone, H. 2016)
Please check all that apply

By completing this form, you are authorizing ACNA Headquarters to submit your name to the ACNA Nominations Committee for consideration as a candidate for office. Notification of official slate of candidates will be sent to the ACNA membership in October. In order to assess our commitment to diversity, the following questions are voluntary and for internal use only.

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