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This form is to credential delegates and alternates to represent nursing schools at the Student Nurses' Association of South Carolina (SNA-SC) convention. To be seated, delegates must register for the convention, complete this form with their school officer, and show proof of enrollment, NSNA membership, and constituency status. The form collects the delegate and alternate's names, NSNA numbers, signatures, and has the school officer certify they are the official representatives for their school.
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- 1. Student Nurses’ Association of South Carolina PO Box 1305 Columbia, SC 29202-1305 SCHOOL DELEGATE CREDENTIAL FORM (Copy, complete and bring this form with you to convention) This form is to be used for the credentialing of the school delegate(s) and alternate(s). In order to be seated in the House of Delegates, the delegate and alternate named below must: 1. Register as a member for the SNA-SC Convention. Proof of NSNA membership must be shown during registration. 2. Complete this form, have a school chapter officer add their NSNA membership number and signature at the end, and take it to Delegate Credentialing after completion of the convention registration process. 3. Show the delegate credentialing committee proof of enrollment (current student ID) in the constituent school of nursing listed below and proof of NSNA membership. 4. Have an Official Application for Constituency status completed for your school by a school chapter officer if one has not already been mailed to the NSNA office. All delegates should complete their credentialing as soon as possible after registering for the convention. PLEASE PRINT School Constituent (Name of School)_______________________________________________________________ Delegate Name_________________________________________________________________ NSNA Membership Number_______________________ Expiration Date________________ Delegate Signature______________________________________________________________ Alternate______________________________________________________________________ NSNA Membership Number______________________ Expiration Date_________________ Alternate’s Signature____________________________________________________________ As the school chapter officer, I hereby certify that the above named are the official delegate and alternate of our association, and are entitled to represent our members in the House of Delegates. Name_______________________________________________________________________ NSNA Membership Number________________________ Expiration Date_______________ Signature________________________________________ Date________________________ School Chapter Officer (title)_____________________________________________________