Application to Run for 2025 NYSENA Officer and Board Member at Large

Deadline - July 7, 2024

* Indicates a Required Field

Name:*

Credentials (License, Degrees, Certifications):*

Date:*

Address:*

City:*

State:*

Zip Code:*

Cell Phone:*

Email Address:* (do not use work email)

Employment Title:*

ENA Membership Number:* (minimum NYSENA member past 3 years)

NYS License #:*

Attendance at 75% of NYSCENA Meeting in past year.

Yes

Board position sought:*

List the activities you have participated in to support your application:*
(may be on state, regional, or national level) ie representative/alt, committees, educator.

Past Organizational / Leadership Experience (ENA and Other):*

Photo requirements:

Need either .jpg or .png format.
Professional digital portrait headshot photograph
- Taken within the past three years
- Professional business attire (no uniforms, scrubs, t-shirts, state council specific attire, etc.)
- At least 5” x 7” or 1500 x 2100 px
- High resolution (minimum of 300 DPI)
- File size must be less than 7MB

We recommend you submit the requirements above to a professional photographer to ensure your photo meets the required specs.

Photo: * (File size must be less than 7MB)

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Election Rules

Please read the Bylaws regarding the election rules.

Bylaws 2024

I have read the election materials on the web site and agree to the election rules: (Your Initials) *

Revised 2024

Address

Phone Number

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