NAPNAP Committee Recruiting Form

Please note: applicants may only apply for one national committee. NAPNAP reserves the right to consider applicants for a different committee position based upon the expertise and experience of the applicant.

Remember - you can save your application and return as necessary before the May 19 deadline to complete all fields and file uploads.

If you wish to apply for the Diveristy, Equity and Inclusion Committee, please click here.

First Name *

Last Name *

Credentials *

City *

State *

Mobile Phone Number *

Email Address *

Confirm Email Address *

To what chapter do you belong *

Years of APRN experience? *

With which gender identity do you identify? *

In which of the following would you place yourself? (Select all that apply) Categories as recommended by U.S. Office of Management and Budget. *

CHAPTER SERVICE: Please list any NAPNAP chapter positions, offices or committee memberships you’ve held.

	Year	Position
1	Year	Position
2	Year	Position
3	Year	Position

SIG SERVICE: Please list any NAPNAP SIG positions you’ve held.

	Year	Position
1	Year	Position
2	Year	Position
3	Year	Position

NATIONAL SERVICE: Please list any national NAPNAP positions, offices, or committee memberships you’ve held.

	Year	Position
1	Year	Position
2	Year	Position
3	Year	Position

Which NAPNAP committee are you interested in serving? *