Nominator Information
Name of Nominator
*
First Name
Last Name
Nominator Email
*
example@example.com
Nominator Affiliation
*
Are you a current SSR member?
*
Yes
No
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Nominatee Information
Select BOD Position
*
Please Select
Vice-President Elect
Director
Name of Nominee
*
First Name
Last Name
Email of Nominee
*
example@example.com
Affiliation of Nominee
*
Link to Nominee's Professional Page
*
Has the Nominee Confirmed His/Her Willingness to be Nominated and to Serve if Elected?
*
Yes
No
Submit
Should be Empty: