Board Nomination Form

Nominee Information: (You must be an active member for at least one full calendar year prior to your nomination to be eligible) *

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Email

Describe the background, skills, and talents of the nominee, especially those that would be of benefit as an Association board
member: *

This person is being nominated because: (Why do you think this person would be a good addition to the GPYTCA Board?) *

Do you think this candidate understands and will commit to the following board expectations?
· Be committed to the vision, mission, and goals of the organization.
· Attend board meetings and events including the annual convention.
· Actively participate on one or more committees or task forces.
· Stay fully informed about the organization, its policies, programs, finances, services, activities, and plans. *

References:
Please provide names and contact information for two or three additional individuals who are familiar with the nominee . They should be willing to support the nomination, and will be contacted by the Nominating Committee.

As the Nominator, I certify that I have the permission of the Nominee named above to submit her/his name for consideration.
Please include your name, address, phone number and email address.