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2026 ANPA BOARD OF DIRECTORS NOMINATION INFORMATION

This is the official application for the ANPA Board of Director open positions for the 2026 Nomination Cycle.
1.Candidate contact information(Required.)
2.Candidate contact information(Required.)
3.Number of hours candidate worked at primary employer(Required.)
4.Please choose the position your are nominating (you may choose only one):(Required.)
5.Candidate professional biography (will be posted for members to review when selecting the best candidate for a position). Limit of 200 words.
6.Please provide three statements why the candidate should be elected to the ANPA Board of Directors. These will be posted for members to review when selecting the best candidate for a position. (No more than 20 words per statement)(Required.)
7.Please attach a professional headshot that will be posted with the biography.(Required.)
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8.Conflict of Interest
Certificate of Agreement and Statement of Disclosure
I have read, understand, and agree to abide by ANPA's Conflict of Interest and Confidentiality Policy (the "Policy"). As a member of the Board of Directors, officer, standing committee member, state representative, or person seeking office within ANPA (collectively, the "ANPA Representatives") I understand that I am obligated to disclose the existence of any facts or circumstances that may constitute a conflict of interest, or breach of confidentiality as those terms are defined in the Policy. Please refer to the Policy, and provide a response to each statement listed below.(Required.)
9.Please list all of the entities and organizations where you currently serve, or have served in the past two years, as an elected or appointed official or as an employee, contractor, volunteer, or consultant. Please include all entities, organizations, roles and dates of involvement. If none, enter NONE.(Required.)
10.If any of the entities or organizations you have listed above has the potential for (i) competing or conflicting with the interests of ANPA; or (ii) taking public positions contrary to those of ANPA, please provide additional information in the space below.If you have nothing to disclose, please enter NONE.(Required.)
11.I have the following financial interests in third parties providing goods and services to ANPA. If you have nothing to report, please enter NONE.(Required.)
12.I have the following personal, direct or indirect, financial interest in the following organization(s), business(es), or product(s) which could affect a decision of the governing body of ANPA. If you have nothing to report, please enter NONE.(Required.)
13.The following members of my family expect to receive some form of compensation or material financial benefit from ANPA. Enter NONE if you have no such members.(Required.)
14.I have the following family relationship or business relationship with the Board of Directors, Officers, or employees of ANPA. If you have nothing to report, please type NONE.(Required.)
15.I wish to disclose the following additional facts or circumstances, including any other events, transactions, arrangements, or other situations that have occurred or may occur in the future that I believe should be reviewed by ANPA in accordance with the terms of ANPA's Conflict of Interest and Confidentiality Policy. If none, enter NONE.(Required.)
16.I understand that I am required to notify the President of any material change in circumstance that may give rise to a breach of confidentiality or a conflict of interest, or that may eliminate a conflict previously disclosed. Further, I understand that I am not to participate in any decision or vote on any issues in which I may have a conflict of interest. I have read and understand the ANPA Conflict of Interest and Confidentiality Policy, and agree to abide by the terms of that Policy.(Required.)
17.By typing my name in the textbox below, I signify that all the information in this survey is correct to the best of my knowledge. I commit to accept the responsibilities of the position for which I am applying should I be the elected member. I have read the Conflict of Interest Policy and agree to the terms thereof. This serves as my electronic signature.(Required.)
18.Please upload your current CV
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19.NOTE: THERE WILL BE A MANDATORY BOARD ORIENTATION IN SEPTEMBER. DETAILS TBD BUT PLEASE SAVE THE DATES