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Appointment to the Domestic Violence Fatality Review Board

Thank you for your interest in serving on the Domestic Violence Fatality Review Board (DVFRB). The ONA Board will review your applications and then submit a list of names to the Attorney General for consideration for appointment. 
First Name(Required.)
Last Name(Required.)
Credentials(Required.)
Home Steet Address:(Required.)
City(Required.)
State
Zip Code(Required.)
Phone Number(Required.)
Email(Required.)
Present Nursing Position (title, employer, and city)(Required.)
Present Association Activities - Please include ways you are involved in ONA/ANA, if applicable.
Please share your domestic violence-related training and experience.
List other Professional and Community Activities
Please provide a statement (100 words or less) of why you are interested in serving on the Domestic Violence Fatality Review Board.(Required.)
Have you discussed your interest with your supervisor and received  support from your organization?(Required.)
Please submit your CV/Resume here.
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