AAENP 2024 Nominations

AAENP 2024 Nominations

Nomination will be open from July 10 to August 9, 2024

Nominee Full Name*

Nominee Organization*

Nominee Professional Title*

Nominee Email Address*

Position Nominating For*

Select

Sustained AAENP Leadership Role*

Select or enter value

Other

File Upload*

In the box below, upload a Resume/CV, Letters of Reference (2), and a Headshot (optional) for the nomination to be considered. Please use the following reference forms:

Board of Directors Reference Form

Secretary-Treasurer Reference Form

No reference form needed for elections and nominations committee

Drag and drop files here or

Responsibilities*

Candidates must be accountable to the responsibilities outlined at this link. Please confirm that you have reviewed these responsibilities.

Background Check Disclosure of Authorization*

I hereby authorize the American Academy of Emergency Nurse Practitioners (AAENP), its affiliates, and designated agents to obtain and review my personal background information. This background check may include, but is not limited to:

• Verification of my professional credentials and licenses.

• Examination of my educational background.

• Review of my employment history.

I understand that the background check is conducted to verify the information I have provided and to assess my suitability for Board of Directors, Secretary Treasurer, or Elections and Nominations committee co-chair candidacy with AAENP. I acknowledge that this information may be obtained from various sources, including government agencies, educational institutions, past employers, and other relevant entities.

Conflict and Confidentiality*

Please fill out the Conflict of Interest and Confidentiality Agreement and attest that you have done so here.

Send me a copy of my responses

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