Application Information

Please use this form to apply for CLPNA Committee positions for the January 2021 to December 2022 term. 

This application and your resume will be screened by the CLPNA's Committee Recruitment team prior to being presented to Council for consideration for appointment.

The CLPNA is committed to safeguarding your personal information.  We will manage this information in accordance with the Personal Information Protection Act (PIPA) and other applicable laws.  For more information on the CLPNA's Privacy Policy, please refer to our website at: https://www.clpna.com/about-clpna/privacy-policies/


Question Title

* 1. Your Contact Information

Question Title

* 2. Upload your Resume

PDF, DOCX, DOC file types only.
Choose File

Question Title

* 3. Do you have an Active Practice Permit from the CLPNA?

Question Title

* 4. What year did you graduate as an nurse?

Question Title

* 5. What year did you become a CLPNA Member?

Question Title

* 6. Do you hold any of the following Advanced Authorizations?

T