CRONA Convention Alternate

This form is intended for use by any CRONA Nurse designated to fill in as an Alternate for an Area Representative at the annual CRONA Convention, held on the first Tuesday in October of each year. If an Area Representative is unable to attend Convention, it is their responsibility to designate an alternate to take their place at Convention. This is for the day of Convention only. It is crucial that CRONA is able to conduct is business at the annual CRONA Convention, as required by our Bylaws. CRONA Nurses interested in becoming an Area Representative must complete the standard Consent to Serve form rather than this form. (Refer to [CRONA Bylaws] for more information).

What is your hospital shift length (8, 10, or 12 hours)?(Required)
This information is used to calculate your pay for attending Convention. You will be paid your hourly rate, without differential, for the same length of shift you work at the hospital.
Please enter a number from 0.00 to 200.00.
Hospital (check one):
Max. file size: 256 MB.
We need a copy of a recent pay slip in order to generate your paycheck for attending the Convention. The pay slip must show your name and hourly rate; it is acceptable to black out other areas if desired. YOU WILL NOT BE PAID UNLESS THIS IS COMPLETE. It is acceptable, though not preferred, to email a copy of your pay slip to crona@crona.org.
I have read the CRONA Campaign Standing Rules as outlined in the CRONA Bylaws. In signing this Consent to Serve form, I agree to uphold the duties of the Office or Appointment I am seeking as outlined in the CRONA Bylaws (for elected positions) or posted job description (for appointed positions). I pledge to be active in the performance of my duties, including engagement with CRONA members, attendance at applicable meetings, bringing relevant issues to the attention of CRONA leadership, and other duties as assigned.(Required)