Willingness to Serve Form

If interested in holding office complete this form and return to a Nominating Committee Member by April 2, 2007.  To be eligible for office, a nominee must have had active AORN membership for one (1) year.

 Place a check mark by the office you are willing to serve.

 OFFICE TO BE ELECTED

_______President-elect (elected annually)

 _______Treasurer (two year term) 2007-2009

 _______Two Board of Director Members (2 year term) 2007-2009       

_______Two Nominating Committee Member* (2 year term) 2007-2009

                   *Solicits members for Chapter Officers and Congress Delegates Elections

Please Print

Name:___________________________________________________________

 Home Phone: _______________________ Work Phone____________________

 How long have you been an AORN member? ____________________________

 Previous AORN offices held: _________________________________________

Signature: ___________________________________ Date: _________________

Nominating Committee:  Jennifer Fey, Chairperson, Louise Bloom and Jan Wharry.  Send or email your completed form to Jennifer Fey 2104 Dry Tortugas Trail, Austin, Tx 78747 or jdeutsch1@austin.rr.com

Get your Form to us by April 2, 2007!