Name:
_________________________________________________________________
Address: _____________________________
City: ______________ State/Prov: ____ Zip/PC:
__________
Phone (H/W) _______________ Fax: __________________
e-mail: __________________________
Place of Employment:
_______________________________________________________________
Current Job Position/Title:
____________________________________________________________
NAHUC Membership Number and Expiration Date :
_______________________________________
If Certified, NAHUC Certification Number and
Expiration Date: _______________________________
|
Candidate
For (Check One): NAHUC
Board of Directors NAHUC Committees NAHUC Committees of the Board (3-year term) Region:
(Circle One) Position:
(Check One) |
Please provide answers to the following questions on a separate sheet of paper. Answers to the following questions must be typed and no more than 300 words total. If you are applying for an elected position, your answers will be printed on the ballots exactly as submitted. 1.
NAHUC Experience (Boards, Committees, Chapters, etc.) To the best of my knowledge, the information I have
given is correct. I
understand responsibilities of the office, including time and financial
considerations, and agree to fulfill the duties of the office. I agree to work within the NAHUC bylaws and policies of
this office and support the mission of NAHUC.
If I cannot continue in the office, I will notify the
chair/director of this Committee/Board or the NAHUC President. Signature: _________________________________________ Date: _____________________________________________ NAHUC, its Committees, task forces and affiliates
encourage members, regardless of race, gender, creed, color, national
origin, religion, marital status, age or sexual preference, to apply for
office on the Board of Directors, Committees, Task Forces, or Affiliates.
Please contact the President-Elect or Committee Chair for more
information. Send completed application, answers to questions 1-5 and copies of current membership and certification cards to NAHUC. Incomplete applications will be returned. Mail
to: Or
fax to: 815-633-4438 or email to: office@nahuc.org Applications for committees must be received by the NAHUC office by December 1 for review at the winter board meeting or June 1 for review at the summer board meeting. Applications for elected office must be received by the NAHUC office no later than 15 days after General Assembly per policy 2304. |