I am interested in active
participation in the Massachusetts Nurses Association:
MNA
General Election
Vice President, Labor*, 1 for 2 years
Treasurer, Labor*,
1 for 2 years
Director, Labor*, 5
for 2 years (one per Region)
Director At-Large,
General, 4 for 2 years
Director At-Large,
Labor, 3 for 2 years.
Nominations
Committee, 5 for 2 years (one per Region)
Bylaws Committee (5
for 2 years) (one per Region)
Congress on Nursing
Practice (6 for 2 years)
Congress on Health
Policy (6 for 2 years)
Congress on Health
and Safety (6 for 2 years)
Center for Nursing
Ethics & Human Rights (2 for 2 years)
*General
means an MNA member in good standing & does not have to be a
member of the labor program. Labor means an MNA member in good standing
who is also a labor program member. Labor Program Member means a
non-RN Healthcare Professional who is a member in good standing
of the labor program
Please type or print – do not abbreviate
Name & Credentials:
__________________________________________________________________________________________
Work Title: ___________________________________________
Employer: ______________________________________________
Home Phone: (
) _______________________________ Work Phone: ( ) __________________________________
Educational Preparation:
SCHOOL
DEGREE
YEAR
Present Offices/Association
Activities (Committee, Congress, Unit, etc.):
MNA
Offices
Region
Offices
Past Offices/Association
Activities, past 5 years only (Committee, Congress, Unit, etc.):
MNA
Offices
Region
Offices
Candidates may submit
a typed statement not to exceed 250 words. Briefly state your
personal views on nursing, health care, and current issues including,
if elected, what your major contribution(s) would be to the MNA
and in particular to the position which you seek. This statement will
be used in the candidate biography and published in the Massachusetts
Nurse. Statements, if used, must be submitted with this consent
to serve.
_____________________________________________________
Signature of Member
_____________________________________________________
Signature
of Nominator (leave blank if self nomination)
Postmarked
Deadline: Preliminary Ballot:
March 31, 2006 Final
Ballot: June 15, 2006
Return
to: Nominations
& Elections Committee Massachusetts
Nurses Association 340
Turnpike Street, Canton, MA 02021
*Hand delivery of material must be to the MNA
staff person for Nominations and Elections Committee only.
*Expect a letter of acknowledgement (call by June 1, 2006 if none received).