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2. NOMINEE INFORMATION
4. Position for which you are nominating this person

   1. President
   2. Vice President
   3. Director of Communications/Secretary
   4. Director of Finance/Treasurer
   5. Director of Programming
   6. Director of Membership Services
6. First Name
7. Last Name
9. Agency
10. Title
12. Address1
14. Address2
16. City
17. State
18. Zip
20. Phone Number
21. Email Address
23. Candidate Statement / Statement of Support
    1800 Characters Max (~250 Words)
25. Candidate Photo
    Please attach a legible photo of the candidate which will be posted during elections.
29. I hereby nominate the candidate listed above for the office(s) indicated. He/she is aware that I am submitting this nomination and has agreed to serve if elected.

    1. I agree
    2. I do not agree
31. Your First Name
32. Your Last Name
34. Your Phone Number
35. Your Email Address
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field