ANA-Ohio Committee Volunteer Application Form

If you are interested in volunteering on an ANA-OH or an ANA-Ohio Foundation committee, please complete this application. Committees include:
  1. ANA-Ohio Foundation Board of Directors
  2. Bylaws
  3. Conference Planning
  4. Continuing Education
  5. Equity, Diversity, Inclusion
  6. Finance
  7. Foundation Scholarships
  8. Governance & Compliance
  9. Legacy 
  10. Outreach & Engagement
  11. Professional Nursing Practice
  12. Public Policy
  13. Publications & Communications
  14. Social Media Subcommittee

REQUIRED

First & Last Name*

REQUIRED

Email Address*

REQUIRED

Credentials*

REQUIRED

Phone Number*

REQUIRED

Primary Practice Area*

REQUIRED

Please select the committee you're interested in serving on:*















REQUIRED

How can you contribute to the committee on which you wish to serve? (Please limit responses to 100-500 words – brevity is a skill and whomever is reviewing these applications will appreciate it. Additional information will be in the biosketch and likely be a repeat of this answer.)*

REQUIRED

Please write a short biosketch OR attach your biosketch as a document below.

REQUIRED

Please attach a short biosketch as a separate document OR complete the question above.
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Please Note -

Submission of this form acts as your electronic signature and acknowledgment that information you provided is true and accurate. Please send any questions you may have to info@ana-ohio.org, or reach out to the ANA-Ohio Executive Director Tiffany Bukoffsky at director@ana-ohio.org. Thank you for your commitment to ANA-Ohio.

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