2026 Board Nominations | Arizona Society for Respiratory Care

Nomination form for a qualified candidate for the Arizona Society for Respiratory Care Officer and Board of Director positions. All nominations must be received no later than September 25, 2026. All qualified nominees will be placed on the ballot, which will be visible on this website on September 26, 2026, after which votes may be cast by AzSRC members until the polls close on November 20, 2026.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Nominee Information

You may nominate yourself for one position only.

Nominee's Full Name*

First Last

Credentials*

For example: RRT, RRT-ACCS, BS, MBA

Nominee's Email Address*

Nominee's Phone Number*

AARC Member Number*

Current Place of Employment*

Current Position Held with Employer*

Years Practicing as a Respiratory Therapist*

Please enter a number from 0 to 70.

AARC / AzSRC Tenure*

How long have you been a member of the AARC / AzSRC?

Education*

List all relevant undergraduate and graduate level education.

Past and Present AzSRC Activity

Optional. Committees, events, volunteer roles, prior board service.

Position Sought

What position are you submitting your nomination for?*

President Elect — 1 position, 4-year term

Vice President — 1 position, 2-year term

Delegate — 1 position, 4-year term

Board Director — 2 positions, 2-year term

You may nominate yourself for one position only.

Headshot & Candidate Statements

Your headshot and statements will appear on the ballot exactly as submitted, so please proofread.

Upload Your Headshot*

Accepted file types: jpg, jpeg, png, Max. file size: 8 MB.

JPG or PNG, 8 MB max. A clear, front-facing photo works best on the ballot.

What does it mean to you to be an AARC / AzSRC member?*

150-250 words.

Your reason for and interest in a Board of Directors position*

150-250 words.

Qualifications statement*

200-400 words outlining your qualifications and why you would be an asset to the AzSRC Board of Directors.

Attestation

I am an AARC member in good standing. I hold a current Arizona Respiratory License and do not have any board actions on record. I understand that as an AzSRC Board member, I must set an example for others in the profession. If an action is placed on my record and I am elected to the AzSRC Board, I will rescind my elected position and remove myself from the board and board activities. My initials represent an electronic signature for this statement.

Type your initials to sign*

Your initials serve as your electronic signature for the statement above.