ACNM 2023 Volunteer Leadership Candidate Consent Form

Thank you for volunteering to be considered as a leadership candidate for office for the 2023 ACNM election.  Should you be elected, you must be willing to carry out the responsibilities of the office as outlined in the ACNM Bylaws which can be viewed on the ACNM Website.

To be an eligible leadership candidate, please submit the form and upload your photo as well as your CV/Resume.

The qualification for any of these roles are:

Current active ACNM membership (prerequisite for eligibility)

Things to consider including in your application (please note: these are not requirements for your application):

Practice experience (i.e. setting)
Academic experience
ACNM volunteer experience (e.g. administration, fund-raising, policy, etc.)
Community involvement
Leadership qualities/style

BEST PRACTICES TIPS BEFORE STARTING:
1) Visit our Elections Page for official position descriptions & terms.

2) Prepare your answers in advance on a word document for easy "cut and paste" completion onto the virtual form. You can take as much time as you need with your document before using the online application form.

3) If you have questions or edits to your online application, contact Jewel Saunders at the ACNM National Office at jsaunders@acnm.org.
The names of potential nominees will be held in confidence by the Nominating Committee and should be held in confidence by the nominees themselves until the ballot is released.  Nominees must use the name and address shown on ACNM records.  By signing next to the appropriate office, I hereby agree to have my name considered by the Nominating Committee on the year 2023 ballot of ACNM. (*if you are interested in more than one office/role, please rank order your interest along with your signature in the box) .

For questions, please feel free to contact Nominating Committee Chair, Linda McDaniel at lmcdaniel777@gmail.com. 

REMEMBER! THE DEADLINE FOR ALL APPLICATIONS IS DECEMBER 16th!

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* 1. Contact Information

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* 2. What are your credentials (as you want them listed on the ballot).

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* 3. What city and state are you currently practicing? If retired, please state if you are currently consulting or volunteering.

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* 4. I am running for the following office:

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* 5. Upload your resume or CV.

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

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* 6. Upload the photo you wish be placed on the ballot and media promotions.

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

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* 7. Biographical Sketch- Copy and paste your bio in the box below. This will be printed on the ballot, must be no more than 300 words and must speak to your experience of the office you are running for.

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* 8. Ballot Question 1: What makes you qualified for this position? Why are you interested in this position?

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* 9. Ballot Question 2:  Visit ACNM's Strategic Plan HERE. What part of the strategic plan embodies your personal philosophy?

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* 10. Ballot Question 3: Visit the Diversity, Equity, Inclusion, and Belonging (DEIB) HERE. What ideas do you have for enhancing diversity, equity, inclusion, and belonging? 

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* 11. Ballot Question 4: What is your vision for innovation and improvement within ACNM?

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* 12. Ballot Question 5: What are two improvements that ACNM should prioritize and how would you help address them in your role? 

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