2023 Board Nomination Form

Name(Required)
Address(Required)
Please indicate area of candidate expertise that matches board of directors priority needs. Consideration to geographic location, diversity and gender will be made.(Required)
Max. file size: 128 MB.
Submitted by(Required)
MM slash DD slash YYYY
Has candidate been contacted to verify their interest in being nominated and serving on the board? (Note - nominator is responsible for contacting individual to validate their interest in serving on the board. You are not guaranteeing them a seat on the board, only validating that if voted in, they would be willing to serve.(Required)
Has candidate been interviewed by either nominating individual or another Board Member?(Required)