2024 CRNA Board Nomination Form

2024 CRNA Board Nomination Form

Legal Name

Nominated Position

Select or enter value

Member Village

Select or enter value

Physical Address

HS/GED Graduation Date

I herby accept the above nomination for the CRNA Board of Directors.

THE FOLLOWING MUST BE COMPLETED TO VALIDATE THIS NOMINATION

Nominations are due March 26th, 2024
A nominee must accept in writing (digital or otherwise) their nomination by April 10th, 2024.
Must be an Alaskan Native and Tribal Member of a Member Village.
Must physically reside in the Ahtna region.
Must have a high school diploma or GED.
Must successfully pass an Alaska Barrier Crimes criminal background check.
Must meet the eligibility requirements of the Indian Child Protection and Family Violence Prevention Act.
Must submit to drug and alcohol testing and a fingerprint background check NO LATER THAN April 17th, 2024.

Type 3 Supporting Signatures*

https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:9c5d5859-9eed-4d22-84bb-e9e9a1dc85d1

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