ASPMN® Participation: (List
present to past)
For the following text fields, we suggest that you type your answers in a word processor and then paste your entries in the fields below. Please limit your entry in this and all subsequent text boxes to a maximum of 750 characters each.
Board positions held and year(s) served. :
Committee(s), position(s) and year(s) served:
Chapters(s), position(s) and year(s) served:
Professional Experience:(List present to past) Job Title, Institution, City/State,
and date(s) of employment:
Experience in field as RN/APN in Pain Management Nursing: years
present to past) Degree(s) earned and date(s):
Certifications: (List dates):
Personal Statement: (200 word limit; What qualifies you to seek this position? Candidates: Please direct this statement to the Nominations Committee at this time, not the ASPMN® Membership.)
Consent: I verify (or have verified with the proper party)
willingness to serve on the ASPMN® Board of Directors or Nominating committee.
Receipt of this Recommendation Form will be acknowledged via e-mail within two (2) business days of receipt in the Executive Office.
If an acknowledgement is not received within this time frame,
please contact the Executive Office at (913) 222-8666.
Please note that a recommendation/nomination
does not guarantee that the person's name will appear on the
slate. Self nominations are permitted.