Nominating Form – Candidates FY 26-27
Iowa Physician Assistant Society

Thank you for your interest in serving on the IPAS Board of Directors.

Please complete the form below to submit your nomination statement for consideration. Responses may be shared with the Nominating Committee and, if applicable, the membership as part of the election process. A headshot may be used to introduce candidates to the membership.

Review the Roles & Responsibilities of the Board

I. Candidate Information

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* 1. Name & Credentials:

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* 2. Email

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* 3. Phone number:

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* 4. Board Position Seeking [check one]

President Elect [1-year] – 3 years in total, including President and Past President Terms

Secretary [2-year]

Director-at-large [2-year]

HOD Representative [4 year]

II. Nominating Statement

Candidate Statement

(Please describe why you are seeking a position on the Board of Directors and what you hope to contribute. This statement will be published for members review. )

Suggested length: 150–300 words.

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* 5. Please provide your statement here:

Relevant Experience & Qualifications

(Include leadership experience, committee service, professional expertise, or volunteer involvement that supports your candidacy.)

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* 6. Please provide your experience and qualifications here:

IV. Commitment & Eligibility

Board Commitment Acknowledgment

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* 7. Please confirm the following (check all that apply):

I am a current Fellow member in good standing.

I understand the time commitment required for board service.

I am able to attend scheduled board meetings and key events.

I agree to uphold the mission, bylaws, and policies of the association.

V. Important Dates

Accepting Nomination Forms – April 1 – May 11, 2026

Final Ballot Confirmed - May 15, 2026

Election Voting Open: May 19 – June 14, 2026

Voting closes: June 14 at 11:59pm

Nominating Form – Candidates FY 26-27Iowa Physician Assistant Society

Question Title

* 1. Name & Credentials:

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* 2. Email

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* 3. Phone number:

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* 4. Board Position Seeking [check one]

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* 5. Please provide your statement here:

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* 6. Please provide your experience and qualifications here:

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* 7. Please confirm the following (check all that apply):

Nominating Form – Candidates FY 26-27
Iowa Physician Assistant Society