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2018 MAR Election: Consent to Serve

2018 Candidate Profile / Consent to Serve Form

Nominations are due by: July 31, 2018

Fields with an asterisk (*) are required.
     
* First Name:   A name is required.
* Last Name:   A name is required.
* Address:   Address is required.
* City/State/Zip:   C/S/Z is required.
* Email Address   A valid email address is required.A valid email address is requiredA valid email address is required.
* Phone:   A phone # is required.
Type:  
Please make a selection.
Phone2:  
Type:  

Best time to call:  
*Office you are Seeking:   Please select office.Please select an item.

Current Title:

 

Current Employer:

 
Employer City/State/Zip:  
Major Area of Responsibility:  
* WOCN member since (YYYY):   Enter 4 digits (YYYY).Minimum number of characters not met.Exceeded maximum number of characters.Invalid format.
* Education:   Education is required.

Past and Present Experiences/Responsibilities outside WOCN contributing to Qualifications for Office:

 
Past Participation in WOCN    

Regional:

 
National:  
* Summary Position Statement:  
* Consent to Serve:   Check to give consent. By checking this box, I confirm that
     
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