Consideration for APRN and LPN Appointment to the Oklahoma Board of Nursing for 2025

Thank you for your interest in serving on the Board of Nursing. The ONA Board will review your application and then submit a list of names to the Governor for consideration for appointment.

The LPN opening is for a nurse in Long Term Care living in a county with a population of less than 40,000 within the geographical districts of 1, 2, 3, or 7

The APRN opening is for an APRN living in a county with a population less than 40,000 within the geographical districts of 2, 5, or 8.

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* 1. I'm licensed as a:

LPN

APRN

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* 2. Which statute designated Geographical District do you live in?

District 1 - Cimarron, Texas, Beaver, Harper, Woods, Alfalfa, Grant, *Kay, Ellis, Woodward, Major, *Garfield, Noble, Dewey, Blaine, Kingfisher and *Logan;

District 2 - Roger Mills, Custer, Beckham, Washita, Caddo, Greer, Kiowa, Harmon, Jackson, *Comanche, Tillman and Cotton;

District No. 3 - *Canadian, *Grady, *McClain, Garvin, *Stephens, Murray, Jefferson, *Carter and Love;

District 5 - Lincoln, Okfuskee, *Cleveland, *Pottawatomie, Seminole, Hughes, Pontotoc, Coal, Johnston, Marshall and *Bryan;

District 7 - *Osage, *Washington, Nowata, Craig, Ottawa, Pawnee,*Payne, *Rogers, Mayes and *Delaware; and

District 8 - *Wagoner, *Cherokee, Adair, Okmulgee, *Muskogee, Sequoyah, McIntosh, Haskell, *Leflore, *Pittsburg, Latimer, Atoka, Pushmataha, McCurtain and Choctaw.

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* 3. First Name

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* 4. Last Name

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* 5. Credentials

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* 6. Home Steet Address:

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* 7. City

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* 8. County

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* 9. State

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* 10. Zip Code

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* 11. Phone Number

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* 12. Email

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* 13. Present Nursing Position (title, employer, and city)

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* 14. I work in

Long Term Care

Acute Care

Primary Care

Other (please specify)

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* 15. List Professional and Community Activities

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* 16. Please provide a statement (100 words or less) of why you are interested in serving on the Oklahoma Board of Nursing.

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* 17. Are you able to meet deadlines and do so regularly and on time?

Yes

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* 18. Have you reviewed the Board of Nursing time commitment requirements and are able to meet them?

Yes

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* 19. Are you aware of the statutory grounds for removal from the Board? This includes not being employed in nursing for a period of 12 consecutive months during your term.

Yes

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* 20. Have you discussed your interest with your supervisor and received support from your organization?

Yes

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* 21. If you wish to submit your CV/Resume, please attach here.

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