NABSW Office of Student Affairs

National Student Officer Nomination Form

PLEASE TYPE OR PRINT

POSITION INTEREST: ___OSA President ___1st V.P.___2nd V.P. ___ Secretary ___Treasurer ___Parliamentarian

PERSONAL

Name __________________________________________________ Date_______________________________

College/University_____________________________________________________________________________

Chapter Affiliation_________________________________________________________________

Address_______________________________________________________________________________________

City_______________________________________ State___________ Zip Code____________________________

Telephone Number (____) ___________________________ E-mail address_________________________________

Academic Level: ____ Fresh. ___ Soph. ____Jr. ____Sr. ____MSW I____ MSW II____ DSW____Ph.D

SUPPORT FOR NOMINATION

Student chapter Advisor or community chapter President supporting this Student’s Nomination (please print name):

___________________________________________________ ___________________________________
Name Signature

____________________________ ____________________________________
Role in Chapter Contact number or e-mail
KNOWLEDGE OF & INVOLVEMENT WITH NABSW/ OSA

Are you a financial student member of NABSW? ____YES ____NO How long? ____Years ____Months

Are you familiar with the policies and procedures of NABSW? ____YES ____NO

I agree to have information about myself including picture and email contact on the NABSW website. _____YES _____NO

On a separate sheet of paper, please answer the following:

1. How would you contribute to the growth and development of OSA?
2. What is your leadership experience?
3. Why do you feel you are a good candidate for the position?
4. What additional information would you like to share?

_________________________________________ _____________________________
Signature of Nominee Date