The WNA Board of Directors is excited to announce the opening of Directors at Large to join the Board. Preference will be given to WNA members based on variety of educational background, practice/employment background and geographical location to ensure a diverse representation for nurses across Wyoming. Applications are due by January 1, 2025. Individuals will be contacted by the Board and appointed at the January WNA Board Meeting.

Question Title

* 1. Name

Question Title

* 2. Credentials

Question Title

* 3. Email Address

Question Title

* 4. Mailing Address

Question Title

* 5. Education - Highest Level and School

Question Title

* 6. Employer and Current Position

Question Title

* 7. Experience relevant to the position:

Question Title

* 8. Elected Offices or other Volunteer Positions Held:

Question Title

* 9. I am a WNA Member and interested in serving in the following position.

Question Title

* 10. Please include any other additional comments you would like to add.

Question Title

* 11. Please type your name to agree with the below statement.
I have read the WNA Bylaws and duties for this office and if appointed, I will serve WNA the interest of professional nursing and abide by the WNA Bylaws, Annual Meeting, Board policies and the ANA Code of Ethics for Nurses. If appointed, it is my obligation to attend meetings and do the work of the position. If I am unable to fulfill this commitment, I will resign. Upon appointed, I will receive links to the following forms that must be completed prior to the first meeting. 1. Volunteer Participation Agreement 2. Conflict of Interest Policy. Completion of the line below serves as the electronic signature of the individal completing this form.

Question Title

* 12. Date Submitted

Date

T