KAEOPP Officer Nomination Profile

KAEOPP Officer Nomination Profile

2021-2023
This profile is needed to complete your KAEOPP officer nomination. You must also secure a completed Statement of Support from your direct supervisor. This statement must be uploaded at the time you complete this application. The form is available here: http://www.kaeopp.org/elections.

This profile must be completed/submitted in a single session. The profile should take 15-30 minutes to complete.
Position sought: *
For a description of the elected positions for KY TRIO, please see Article IV of the KY TRIO Constitution.

In order for your nomination be approved for a regional representative, your office must be located in the appropriate region (East, Central, or West) according to the map submitted of Regions for KY TRIO.
Contact Information
Personal
Name *

First Name Last Name
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone Number

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Business
Institution/Agency *
TRIO Programs(s) *
Business Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Office Phone Number *

Area Code Phone Number
Office Fax Number

Area Code Phone Number
E-mail Address *

Employment Information
Your Current Position *
Job Title
Total years in TRIO *
Number of years
Length of Time in Your Current Position:
*
Years
*
Months
Length of Time at Your Institution/Agency:
*
Years
*
Months
Please list your most recent full time TRIO positions prior to your current position. On a new line after the headings, complete the information. *
Institution/Agency | TRIO Program | Title | Employment Dates
----------------------------------------------------------------------
Please list any other relevant full time employment, outside TRIO Programs.
Institution/Agency | Department | Title | Employment Dates ----------------------------------------------------------------------

Leadership Information
Describe your experience/service as an elected officer, committee chair/co-chair/member, or other positions. *
Length of Time as a KAEOPP Member:
*
Years
*
Months

The Statement of Support must be uploaded by you at the time you complete this application. To complete this form, print it, and have your director supervisor complete the form. Then scan the form, and have it ready to upload at the time you submit the application.

The form is available on the KAEOPP Elections webpage: http://www.kaeopp.org/elections.
Please upload the completed Statement of Support here: *
Statement of Understanding
By checking the first box (below), you affirm the following: (1) that you are an active professional member of KAEOPP; (2) that you are aware of the duties and responsibilities of the office you seek, and have read these duties in the KAEOPP Constitution; (3) that you are able to commit the time and effort necessary to perform your duties effectively; (4) that you will be able to attend quarterly meetings as appropriate to the position sough (KNCT-3, Spring Meeting for everyone; SAEOPP BOD Meeting in May, September, December, and prior to the Annual Conference for President & Vice-President; (5) all information contained in this document is accurate and true to the best of your knowledge; and (6) that your are aware of your fiscal responsibilities as a Board member. *

I agree, and authorize that this check box represents my online signature I do NOT agree (checking this box results in an incomplete application).
Should be Empty: