Board of Directors Nomination Form Nominated By *Nominator's Phone *Select *Select the position nominated for.PresidentVice PresidentSecretaryTreasurerBoard member at LargeChapter 1 PresidentChapter 2 PresidentChapter 3 PresidentChapter 4 PresidentChapter 5 PresidentChapter 6 PresidentChapter 7 PresidentChapter 8 PresidentChapter 9 PresidentName of Nominee *Credentials *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodePhone *Email Address *Hospital/Institution Affiliation *Title *Consent *I accept the nomination for the 2024 LSRC Board of Directors and verify that I am a current AARC/LSRC member and will maintain my active AARC/LSRC membership for the duration of my elected term in office. AARC Member # *Expiration Date *Send Message
