2026 Kentucky 811 Board of Directors Nomination Form

2026 Kentucky 811 Board of Directors Nomination Form
Nominee Information
Nominee Name
Nominee's Job Title
Company/Organization
Nominee Phone Number
Format: (000) 000-0000.
Nominee's Email Address
example@example.com
Company/Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company/Organization Website
Company/Organization Phone Number
Format: (000) 000-0000.
Individuals may nominate themselves or be nominated by a representative of a KY 811 member organization. Self-nominations require a letter of support from a supervisor to be considered.
Is this a self-nomination?
I confirm the nominee is employed by a current Kentucky 811 member organization.
I confirm organizational support.
Please provide a brief bio or summary of relevant experience, leadership and commitment to utility safety.
The positions listed below are open for nomination due to expiring terms or current vacancies. Incumbent directors whose terms are ending may be nominated for another term.
Board Seats Available for Nomination
Supervisor Letter of Support

Cancelof
Nominator Information
Name of Person Submitting Nomination
Company/Organization
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I have the authority to make this nomination on behalf of the organization.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Only employees of current Kentucky 811 member organizations are eligible for nomination. Nominations must be submitted by an individual who is authorized to nominate candidates on behalf of the member organization.
Should be Empty:

2026 Kentucky 811 Board of Directors Nomination Form

Nominee Information

Individuals may nominate themselves or be nominated by a representative of a KY 811 member organization. Self-nominations require a letter of support from a supervisor to be considered.

The positions listed below are open for nomination due to expiring terms or current vacancies. Incumbent directors whose terms are ending may be nominated for another term.

Nominator Information