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NCPA Candidate Information Form
Please complete this form to submit your nomination for your candidacy prior to the Annual Business Meeting on August 17, 2024. Candidates will be posted on the NCPA website for member review.
Your website
First name
Last name
Email
Mobile
Office Name
Chiropractic School Attended
Years of Practice
Years NCPA Member
Professional Affiliations or Additional Education Credentials
Position Running For
-- Please Select --
Omaha District
Lincoln District
Southeast District
Northeast District
At Large
Vice President
Treasurer
Secretary
Peer Review Committee- Position 1
Peer Review Committee- Position 2
Previous Positions Held within the NCPA (if any)
Why are you interested in serving on the NCPA board?
How do you plan to contribute to the growth and development of the NCPA?
Please share any other information you feel is relevant for voters to know about you
Submit
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