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Interested in joining the WSNA Board of Directors? Complete the Nomination and Biographical Information Form below to apply to be a board member for the 2025-2026 year. Choose from two submission options:

Apply online. Your submission will be sent to Nominations Director, Maggie Zuelhke.
Download the form. Fill out and email the form to Nominations Director, Maggie Zuelhke.

Regardless of submission method, pictures of each candidate will be taken by the nominations director and included with the form.

Please Note: This form will be displayed in the exact condition in which you submit it. Make sure all fields are filled out completely and accurately.

Nomination and Biographical Information Form

Name

First Name

Last Name

Nomination

Goals

State your specific goals for the office you are seeking, and how would you attempt to achieve them if elected.

Organization Experience

List any offices, positions, committees or projects you have held/been involved with. Include date of term, type of activity, and your accomplishments.

WSNA

Please include date of term, type of activity, and your accomplishments.

Local SNA Chapter

Please include date of term, type of activity, and your accomplishments.

School Organizations

Please include date of term, type of activity, and your accomplishments.

Service Activities

Please include date of term, type of activity, and your accomplishments.

Additional Experience

List any other education background qualifications, conferences attended, and extracurricular activities which enhance your qualifications for the desired office.

Ballot Name

Please list your name as it will appear on the ballot.

School of Nursing

Program Completion Date

YYYY

School Residence Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Residence Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Other positions for which you are willing to be considered:

If not elected, would you like to be contacted to become a member of the Executive Cabinet?

Yes

NSNA Number

Chapter President

Expiration Date

YYYY

Confirmation

If elected, I agree to serve the Wisconsin Student Nurses’ Association to the best of my abilities and am aware of the time and effort demanded by the responsibilities outline for the office to which I am nominated.

To the best of my knowledge, all statements on this form are true. I realize that any falsity, incompleteness, or failure to follow directions, on this form may result in my disqualification as a candidate and/or WSNA officer.

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