Statement of Support Form

Please complete this form if you are an NSCN registrant supporting the nomination of another registrant to serve on the NSCN Board in 2021. Please submit this form by Friday, April 16 at 1 p.m.  Before you begin, please note:

  • All sections are required.
  • Incomplete or late forms will not be considered.

If you have any questions or require further assistance, please contact Shelly Spears, Customer Experience Coordinator, at

Your First/Last Name
Your Designation
Search for a Nurse is available to confirm number

Statement of Support


Certify Application


Click SUBMIT to send your application to NSCN.