ONCB Director Application

If you would like to learn more about the Director role and responsibilities, please download the information packet.
Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Preferred Phone Number *
Email *
Employer's Name
Employer's Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Current Position *
Primary Responsibilities *
Education *
NAON Member *
YesNo
Date certified by ONCB *
ONCB Credential *
ONCONP-COCNS-CONC-A
Number of years in orthopaedic nursing *
RN Licensure State *
Professional Associations (include role & dates; may also identify on CV)
List any nursing awards
Certifications (other than ONCB)
If you were not selected as ONCB Director, would be interested in another volunteer position with ONCB? *
YesNo
Upload Curriculum Vita/Resumé *
Please submit two letters of recommendation based on the template provided in this packet. Recommendations should be from professional contacts; at least one should be from a supervisor. *
Nominee Statement Please address each question (typewritten and double-spaced) noted in the attached Nominee Statement and upload to the area below.
Nominee Statement responses upload here *
Attestation *
I hereby state all information provided is accurate to my knowledge. I agree that, if selected to serve on the ONCB, I will be able to commit to a 3-year term of office and to the time necessary to fulfill the role of ONCB Director. I understand by agreeing to serve on the ONCB, I will not be eligible to recertify by examination during my tenure and for a period of 2 years following my tenure on the ONCB.Yes

Verification

Please enter any two digits *Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:

ONCB Director Application

ONCB Director Application

Verification

Contacts