LeadUS Mentoring Program 2015-16

Board of Directors Applicant or Nomination Form

I nominate myself, or, the following candidate to stand for election to the Board of Directors of the CSAAA for a three-year term, June 2024-May 2027.
Your Information
Name*

Last NameFirst Name
Date*

MonthDayYear
Date
Email*
example@example.com
Address

CityProvince

Zip CodeCountry
Nomination Information

Please enter the information for the person being nominated, or your own information if you are applying for the board of directors elections for the 2024-2027 term. This is a voluntary role. The CSAAA board of directors meet virtually on the first Thursday of every month. For more information, please contact Jenn at info@csaaa.org or 705-875-2302.
Nominee Name*

Last NameFirst Name
Position Applying or Nominating For*
Title/Profession*
Business*
Email*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
If applying, please write a short bio that will be displayed on the election form. If nominating, please list any relevant industry information on nominee.*
current position/duties/reason for applying/longevity in industry/experience/etc
If any - what are your/the nominee's current association, organization and/or club affiliations? (include titles if possible)
Thank you for your interest.

I certify, by my signature, that the information contained within this application is true, accurate, and complete to the best of my knowledge. An electronic signature is accepted.
I am applying for the board of directorsThe person I have nominated has been notifiedThe person I have nominated has not been notified
Signature*

Powered by Jotform SignClear
Should be Empty:

Board of Directors Applicant or Nomination Form

Your Information

Nomination Information