RN Liaison Program Application Survey

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Please provide your email address.

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Please provide your phone number.

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Please provide your employer's name.

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Please provide your city/region in Ohio.

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How many years of RN experience do you have?

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What is your primary specialty area?

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Are you a current OSANA member?

Yes

Unknown

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Which best describes your current stage?

Exploring nurse anesthesia

Planning to apply within 1–2 years

Currently preparing applications

Interviewing

Accepted to a program beginning after the upcoming term

Other (please specify)

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Do you anticipate being available to fulfill a one-year commitment?

Yes

Unsure

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Select all committee interests that apply.

Professional Outreach and Engagement

Wellness

Communications

Programs

Political Action Committee

Open to any committee assignment

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Why are you interested in participating in the OSANA RN Liaison Program? (150 words or less)

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What strengths, experiences, or perspectives would you bring to an OSANA committee? (150 words or less)

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What are your professional goals, and how do you hope participation in this program will support them? (150 words or less)

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Upload current resume or CV.

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Please provide one professional letter of reference.

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Please provide the name of your professional reference.

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Please provide the credentials of your professional reference.

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Please provide the relationship to the applicant.

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Please provide the email address of your professional reference.

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Select up to three areas of interest.

Outreach

Education

Event planning

Communications

Social media

Writing/blog development

Wellness initiatives

Membership engagement

Volunteerism

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Which activities would you potentially be willing to participate in? (Select all that apply)

Virtual meetings

Career fairs

High school outreach events

Nursing student information sessions

Virtual educational programs

Social media or communications projects

Writing blog content

Data collection or surveys

Event planning

Other (please specify)

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I understand that participation generally requires attendance at periodic committee meetings and completion of project-based tasks throughout the year.

I acknowledge this expectation

RN Liaison Program Application

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* Please provide your full name.

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* Please provide your credentials.

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* Please provide your email address.

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* Please provide your phone number.

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* Please provide your employer's name.

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* Please provide your city/region in Ohio.

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* How many years of RN experience do you have?

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* What is your primary specialty area?

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* Are you a current OSANA member?

Question Title

* Which best describes your current stage?

Question Title

* Do you anticipate being available to fulfill a one-year commitment?

Question Title

* Select all committee interests that apply.

Question Title

* Why are you interested in participating in the OSANA RN Liaison Program? (150 words or less)

Question Title

* What strengths, experiences, or perspectives would you bring to an OSANA committee? (150 words or less)

Question Title

* What are your professional goals, and how do you hope participation in this program will support them? (150 words or less)

Question Title

* Upload current resume or CV.

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* Please provide one professional letter of reference.

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* Please provide the name of your professional reference.

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* Please provide the credentials of your professional reference.

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* Please provide the relationship to the applicant.

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* Please provide the email address of your professional reference.

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* Select up to three areas of interest.

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* Which activities would you potentially be willing to participate in? (Select all that apply)

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* I understand that participation generally requires attendance at periodic committee meetings and completion of project-based tasks throughout the year.

Please provide your full name.

Please provide your credentials.

Please provide your email address.

Please provide your phone number.

Please provide your employer's name.

Please provide your city/region in Ohio.

How many years of RN experience do you have?

What is your primary specialty area?

Are you a current OSANA member?

Which best describes your current stage?

Do you anticipate being available to fulfill a one-year commitment?

Select all committee interests that apply.

Why are you interested in participating in the OSANA RN Liaison Program? (150 words or less)

What strengths, experiences, or perspectives would you bring to an OSANA committee? (150 words or less)

What are your professional goals, and how do you hope participation in this program will support them? (150 words or less)

Upload current resume or CV.

Please provide one professional letter of reference.

Please provide the name of your professional reference.

Please provide the credentials of your professional reference.

Please provide the relationship to the applicant.

Please provide the email address of your professional reference.

Select up to three areas of interest.

Which activities would you potentially be willing to participate in? (Select all that apply)

I understand that participation generally requires attendance at periodic committee meetings and completion of project-based tasks throughout the year.