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* 1. I wish to run for: (Select one)

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* 2. Contact Information

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* 3. Sigma chapter(s) in which you are an active member:

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* 4. Sigma Member ID number:

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* 5. Are you interested in learning about additional roles if you are not slated for your desired role?

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* 6. Are you currently serving on a board for an organization other than Sigma?

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* 7. If yes, please include what organization(s) and describe your role:

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* 8. I understand that my name has been placed on the Phi Pi Chapter 2026 ballot for the office indicated above and, if elected, I will accept the position and fulfill the responsibilities of this office or committee in accordance with the bylaws, policies and procedures.

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* 9. Please provide a short biography that can be shared with the chapter members as to your qualifications for the position.  You can also add why you are seeking this position (no more than 300 words--see example below).
 

SAMPLE BIO: XXX received her MSN and EdD from West Virginia University and her MPH and Post-Doctoral Research Fellowship in Biomedical Informatics from the University of Pittsburgh. XXX is currently a Core faculty member in the DNP Program at XYZ University. Professionally, XXX has worked as a researcher in the area of consumer health informatics and has mentored graduate students and junior faculty colleagues. XXX served the Walden University chapter of the Nursing Honor Society and Phi Pi as faculty counselor from 2009 – 2012 and is currently serving as Governance Committee chair. XXX has previous experience serving as Treasurer for the Alpha Rho chapter of STTI for two consecutive terms. She currently serves as a member of the Sigma International Nurse Leader Review Committee and is also a Sigma Billye Brown and Virginia Henderson Fellow.

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* 10. Please Provide Headshot

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