2026 Board Nomination Form

First Name *

Last Name *

Credentials *

Email *

Phone *

Candidate First Name *

Nominee Last Name *

Candidate Credentials (if known)

Candidate Email *

Confirm Candidate Email

Candidate Phone (if known)

Candidate's APSNA Membership Status *

The person I am referring is a member in good standing of APSNA.

Why do you think you or this person would make a good national leader for APSNA? *

What available role do you think you or this person can best fill? *

President Elect (2026-2027)

Director of Practice & Quality (2026-2028)

Director of Program (2026-2028)

Secretary (2026-2028)

May a Nominations Committee member reference your name when contacting the referred candidate? *