Board Candidate Personal Profile

First Name *

Last Name *

Credentials/Professional Licensure *

Office/Board Position You Seek *

Enter required value President Elect (2026-2027) Director of Practice & Quality (2026-2028) Director of Program (2026-2028) Secretary (2026-2028)

Place of Current Employment *

Current Job Title *

Major Areas of Responsibility *

Educational Background/Degrees Held/Special Certifications *

Summary of Your Goals for the Position *

(Please review Category A – Evaluation Tool Criteria)

Past or Present Leadership Experiences and Responsibilities *

Past or present leadership experiences and responsibilities that contribute to your qualifications for the office sought: (If you do not have leadership experience, please include whether you have interest in being mentored in a leadership role.) Please provide a summary of your:

1. Leadership skills
2. Organizational skills
3. Communication skills
4. Computer skills
5. Ability to work with others
6. Commitment to the profession of nursing and the growth and development of the specialty of pediatric surgical nursing.

How Many Years Have You Been an APSNA Member? *

(A minimum of 2 years within the past 5 years of membership is required to run for a board position.)

List Your Previous or Current Involvement on APSNA Committees or Board of Director Positions *

(If you have not had previous experience on an APSNA committee or board position, please include whether you have interest in being mentored in such a position.)

Submit Recent Curriculum Vitae with Your Application *

Please upload in Word or PDF format.

20MB max

Submit Professional Headshot *

Please upload a jpg, png, gif or PDF

20MB max

Letter of Recommendation *

(requested to be written by a non-APSNA member nurse or colleague). This letter should address your qualifications for holding a board of directors’ position by speaking to your professional accomplishments and leadership potential. Specifically:

1. contributions to APSNA or demonstration of leadership abilities,
2. vision, creativity, innovation, and professional communication,
3. self-direction/ability to meet deadlines,
4. quality of work,
5. accountability and
6. professional integrity.

This letter may be found and submitted online here.

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