2024 Board Director Nomination Form

Nominees for the board must be members of ARNM and, if currently practising, registered (with no limitations on practice) with their applicable college.

Nominee Information

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* 1. Name

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* 2. Are you a member of ARNM?

Yes

If not a current member, please contact us to register at info@arnm.ca

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* 3. Are you a member of the following:

CLPNM

CRNM

CRPNM

None of the above

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* 4. Registration/ID number

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* 5. Contact information

Phone Number

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* 6. By checking this box, I consent to be included as a board director nominee.

Yes

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* 7. By checking this box, I consent to have reviewed and agreed to the Conflict of Interest Policy.

Yes

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* 8. By checking this box, I consent to have reviewed and agreed to the Board Director Job Description.

Yes

Nomination Endorsement

Nominations must be endorsed by two ARNM members.

Nominator One

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* 9. Name of nominator

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* 10. Registration/ID number

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* 11. Email address

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* 12. In lieu of a signature, by checking this box I confirm that this individual has consented to nominate me.

Yes

Nominator Two

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* 13. Name of nominator

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* 14. Registration/ID number

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* 15. Email address

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* 16. In lieu of a signature, by checking this box I confirm that this individual has consented to nominate me.

Yes

Statement of Intent

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* 17. Your statement of intent will be posted alongside your name on the voting ballot (maximum 200 words). Please provide a brief description of:

Why you want to be on ARNM's board of directors

The skills you will bring to the board of directors

Attachments

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* 18. Nominee resume

PDF, DOC, DOCX file types only.

Choose File

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* 19. Nominee headshot (optional)

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

Choose File

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* 20. Letter of Support (nominator one )

Please provide a brief description of why the nominee should be on ARNM's board of directors and the skills they would bring.

PDF, DOC, DOCX file types only.

Choose File

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* 21. Letter of Support (nominator two)

Please provide a brief description of why the nominee should be on ARNM's board of directors and the skills they would bring.

PDF, DOC, DOCX file types only.

Choose File

Question Title

* 1. Name

Question Title

* 2. Are you a member of ARNM?

Question Title

* 3. Are you a member of the following:

Question Title

* 4. Registration/ID number

Question Title

* 5. Contact information

Question Title

* 6. By checking this box, I consent to be included as a board director nominee.

Question Title

* 7. By checking this box, I consent to have reviewed and agreed to the Conflict of Interest Policy.

Question Title

* 8. By checking this box, I consent to have reviewed and agreed to the Board Director Job Description.

Question Title

* 9. Name of nominator

Question Title

* 10. Registration/ID number

Question Title

* 11. Email address

Question Title

* 12. In lieu of a signature, by checking this box I confirm that this individual has consented to nominate me.

Question Title

* 13. Name of nominator

Question Title

* 14. Registration/ID number

Question Title

* 15. Email address

Question Title

* 16. In lieu of a signature, by checking this box I confirm that this individual has consented to nominate me.

Question Title

* 17. Your statement of intent will be posted alongside your name on the voting ballot (maximum 200 words). Please provide a brief description of: Why you want to be on ARNM's board of directors The skills you will bring to the board of directors

Question Title

* 18. Nominee resume

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* 19. Nominee headshot (optional)

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* 20. Letter of Support (nominator one )

Question Title

* 21. Letter of Support (nominator two)

* 17. Your statement of intent will be posted alongside your name on the voting ballot (maximum 200 words). Please provide a brief description of:

Why you want to be on ARNM's board of directors

The skills you will bring to the board of directors