First Name:
Last Name:
Supervisor's Name
Group Selection
The individual completing this form is:
The nominee
The nominee's supervisor
Other...
Group Selection
Does the nominee have prior approval from his/her supervisor to be a candidate for election?
Yes
No
Other...
Group Selection
Is the nominee available to meet the third Tuesday of every month for the regular Board meetings?
Yes
No
Other...
Please explain why you would like to be a member of the CECH Staff Board. Or, if nominating another individual, please explain why this person would make a good member of the Board. (Please limit to less than 300 words).
Submit
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