CPCNA Board of Directors Nomination Form

In preparation for our Annual General Meeting (AGM) the CPCNA is seeking volunteers interested in holding an elected position on the CPCNA Board of Directors.  This is an excellent opportunity to support palliative care nursing across Canada, develop and demonstrate leadership skills and contribute to the success of your organization!

Please complete each section of the nomination form below.

  • The nominee MUST agree to be nominated.

  • The nominee MUST be a CPCNA member.

  • The nominator MUST be a nurse regulated in Canada (CPCNA membership not required).

    • If the nominator is not a Member of CPCNA, an additional Letter of Support will be required. ​

  • The nominee MUST meet the criteria for directorship in the CPCNA bylaws and role description in order to be eligible.

Please complete the form below and email Nomination Letters, Letters of Support (if indicated) and a photo to cpcnainfo@gmail.com. 

The deadline for nominations is March 1, 2022

 

Nominee Information (information collected is used in accordance with the CPCNA privacy policy posted at www.cpcna.ca.  For the purpose of this application, information will be only shared with the CPCNA Board.

CPCNA Board Nomination Form 
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A. Nominee Information

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B. Nominator Information

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C. Nominee biography and reason for seeking position on the Board

(250 words or less).

D.  Letter of Support from Nominator for the Nominee (250 words or less). 

 

NOTE: This section needs only to be competed if the NOMINATOR is not a member of CPCNA.  Should include:

  • writer relationship to nominee

  • discuss how the nominee can support the Mission, Purpose and Vision of CPCNA

  • discuss what skills the nominee will bring to the Board

E. Nominee’s Photograph

Website does not support photo uploads.

 

 

To be less than 500 kb, in jpg, png or gif format). 

Click the following to confirm:

Thank you for submitting this Board Nomination!