MASSACHUSETTS EMERGENCY NURSES ASSOCIATION

NOMINATION APPLICATION for

2008 STATE COUNCIL OFFICER ELECTION

 

STATE COUNCIL OFFICE YOU ARE APPLYING FOR:

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NAME:  _____________________________________________________

CREDENTIALS:  ______________________________________________

WORK TITLE:  _______________________________________________

PLACE of EMPLOYMENT:  _______________________________________

HOME ADDRESS:  _____________________________________________

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PHONE:  ____________________      E-MAIL:  ________________________________

ENA EXPERIENCE (please limit this to 8 items):

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In 50-75 words, please write a statement on what you feel the goals that Mass ENA should focus on for 2008:

 

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Please return this application to Faye Everson at 64 Ebenezer Lane, Brewster, MA  02631 by July 1, 2007.