Election Application

***Must be a SCAPHON member to apply***

APPLY OR NOMINATE HERE
Name of candidate:
First Last
Office under consideration*
Please check one
- Treasurer (2 year position; must have served at least one term on any SCAPHON committee)
- Quarterly Program Chair (2 year position; no previous experience required)
Current work position*
Include job title and institution name
Cell phone*
Email*
Educational preparation*
Include degrees, dates, institutions, certifications
Past participation in APHON/SCAPHON:*
Past/Present experiences-responsibilities contributing to qualifications for office:*
State briefly why you wish to run for office:*
Please write out name and credentials as you would like them to appear in the ballot:*
If you are nominating someone other than yourself, have you contacted this candidate?*
- Yes
- No
- N/A
Please attach a current picture*
Drop files here or

Max. file size: 128 MB.