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2023 Nomination Application Form

Personal and Member Indentification Information

1. Personal Information *This question is required.
2. What types of Programs/Institutions are represented by your organization? *This question is required.
This question requires a valid number format.
3. Gender *This question is required.
PLEASE NOTE:  All Board of Governors' members must attend the Annual Business meeting at the NLN Education Summit scheduled in September.
5. Please select all roles that you have experience in and write brief examples for each. *This question is required.
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6. There are four open positions for the 2023 elections. Please select up to three positions and rank them in the order of your preference. *This question is required.
Space Cell NLN Chair-electTreasurerGovernor-at-LargeNominations Committee MemberCertification Commissioner
First Preference
Second Preference
Third Preference
Please Note: the position of the Certification Commissioner requires an NLN certification (CNE/CNEcl/CNEn).

I hereby certify that I currently hold an active or retired certification from the NLN. *This question is required.
7. I would be willing to be contacted by the Nominations Committee for other NLN opportunities. *This question is required.
12. Please attach your current abbreviated curriculum vitae (CV),  no more than 7 pages in length. Substantiate your primary area of contribution to nursing education and emphasize your accomplishments (e.g. involvement in professional organizations including serving on committees, panels, task groups, publications, presentations, awards, etc.).

Include in your CV information on how you contributed to innovative teaching strategies, community and global engagement, inter-professional alliances, mentoring, under-served communities, financial or fiduciary responsibilities and public policy.

Remember to modify your CV to align with the position you have selected.

Applicants who submit CV's longer than 7 pages will not be considered. *This question is required.
13. The National League for Nursing (NLN) is a tax-exempt, not-for-profit organization. In order to maintain tax exempt status, all interested persons must comply with guidelines and procedures of the NLN conflict of interest policy. In accordance with this policy, I acknowledge that I will disclose any and all actual, potential or perceived conflicts of interest with the NLN or its entities. I also acknowledge that I am responsible to update all disclosure information at such time that any changes occur. *This question is required.
Do you acknowledge the above statement and agree? *This question is required.
Do you have a conflict you wish to disclose? *This question is required.
Thank you for completing the Nominations Application & Bio-Sketch. The information you have submitted has been received as part of the nominations process at the National League for Nursing. All nomination information received is maintained as confidential and is used solely for the purposes of developing a slate of candidates for the annual ballot.