Council Nomination Form

  • Council Nomination Form

    Please complete all sections of the nomination form accurately and thoroughly. Provide sufficient detail to support the nominee’s qualifications and experience. Once submitted, nominations will be reviewed, and eligible individuals will be invited to submit a formal application for consideration.

  • Nominee Information

    Please provide complete and accurate information for the individual being nominated. This information will be used to contact the nominee and confirm eligibility. If you are submitting a self-nomination, complete this section with your own information. Ensure all contact details are current, as the organization may reach out for follow-up or next steps in the selection process.

  • Nominator Information

    Please provide your information as the individual submitting this nomination. This information allows the organization to follow up if clarification or additional details are needed. If you are submitting a self-nomination, you do not need to complete this section. All information will be used solely for evaluation purposes by the nominating committee.

  • Seat(s) Individual is Nominated For: Indicate the board seat(s) for which the individual is being nominated. Select all applicable options if the nominee is being considered for more than one seat.*

  • SCCM Involvement

    Please briefly describe the nominee’s involvement with SCCM (e.g., section participation, committee service, leadership roles, volunteer activities):

     

  • Nominee Qualifications

    Why is the nominee qualified to serve on the SCCM Council? 

    Please provide a brief statement highlighting relevant experience, expertise, or perspective.

  • Nominee's Leadership Experience

    Describe the nominee’s leadership experience. High-level summary—e.g., leadership roles, team management, organizational impact.

  • Has the nominee agreed to be considered for this role and is willing to serve if selected?*
  • Should be Empty: