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* Nominator 

Name

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* E-mail address:

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* Telephone (with area code):

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* Nominee 

Name

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* Address

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* Province/Territory:

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* Telephone (with area code):

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* E-mail address:

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* Current position:

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* Employer:

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* Statement of philosophy (maximum 200 words) 
The statement should indicate the nominee’s rationale for accepting the nomination and outline his or her ability to bring to the board a broad perspective from outside the nursing profession that informs and strengthens dialogue and decisions at the board table.

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* Candidate's Platform Message (maximum 200 words) 
This message provides candidates with a further opportunity to speak to their focus for CNA during their term of office.

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* The nominee has consented to the nomination

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* Please attach a brief curriculum vitae (CV) of the nominee

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* Upload Candidate's Color Photo

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FOR FURTHER INFORMATION
Coordinator of Governance and Leadership
Canadian Nurses Association
50 Driveway, Ottawa, ON  K2P 1E2
1-800-361-8404, ext. 207, or
e-mail: nhammude@cna-aiic.ca

Privacy policy: Personal information collected on this form will be used only for processing nominations and related follow-up.

 

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