Executive Officer Nomination Form

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:


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

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field