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2025 Nomination Form for Elective Office

Candidate Information

This information is used by the Pennsylvania Chapter Committee on Nominations and Leadership Identification (CCNLI) to make nominations for elective chapter positions, for chapter committees and task forces. To be considered for an elected position, please provide your resume and cover letter which addresses your qualifications for nomination (i.e. strengths/skills that will move NASW-PA forward). Submissions are due by March 15th.
1.Nominee Contact Information(Required.)
2.At what email address would you like to be contacted?
3.Credentials
4.What are your preferred pronouns?
5.You must be a member of NASW Pennsylvania Chapter to run for office.  Are you currently a member of the Chapter?  If not a current member, do you commit to join?
6.License Number (if applicable)
7.Students - University
8.Students - Degree Sought
9.Students - Graduation Date
10.Please check positions that you are willing to be nominated for. Note that to run for Division Chair or Rep you must be a member of that division. Refer to the division map at www.nasw-pa.org/BOD. You may run for only one position at a time, with the exception of delegate to Delegate Assembly. Candidates may run for any other office and also run as a delegate.(Required.)
11.If we are unable to slate you for the selected position(s), would you be willing to be slated for any other position?(Required.)
12.Have you or do you have pending:(Required.)