Nomination Form – National Board Position

NOMINATION FORM FOR NATIONAL BOARD POSITION
Please complete this form and submit by May 31, 2018.
Nominee Name:*
Address:
Phone:
-
E-mail:*
Employer:*
Position:*
Credentials:*
Year Joined CSGNA:*
Chapter/National Positions Held:*
Committee Participation:*
Other related activities:*
Select from the list the position for nomination:*
Reasons(s) for submitting the nomination for National Office: (can include your objectives, position statement, purpose, interest) *
Upload CV/Resume:*
Nominator 1 Name:*
Nominator 2 Name:*