THE PHILIPPINE NURSES ASSOCIATION OF MICHIGAN
CANDIDATE’S PROFILE AND NOMINATION FORM
(All Positions are for one term (two years)

          Name _____________________________________________________________________

          Adddress ___________________________ City ______________ State ____ Zip ________

          Telephone (H) _______________________ E-mail _________________________________

          Work Address ____________________________________ Position ___________________

          Please check off (ü) the Position you are running for: (one only):

          ___ President-Elect                  ___ Treasurer                           ___ Business Manager

          ___ Vice President                   ___ Assistant Treasurer            ___ Assistant Business Manager

          ___ Secretary                           ___ Auditor                              ___ Board Member

          ___ Assistant Secretary            ___ Public Relations Officer

          Describe in a brief statement of less than 50 words why you want to run this position:

          I WILL SERVE AND FULFILL THE RESPONSIBILITIES DESCRIBED IN THE BYLAWS OF THE OFFICE TO WHICH I AM ELECTED       

          ______________________________   ______________________________   _______________
          Print Name                                        Signature                                          Date

          I am a current paid member for the last two consecutive years as verified and signed by the Membership Committee Chairperson

          _________________________________________              ______________________________
          Signature of Membership Committee Chairperson               Date

© 2008 PNAM