AGM Office Bearer Election Form

AGM Office Bearer Election Form
Submit your nomination for the AGM office bearer election. Please complete all fields to ensure your nomination is processed.
Nominee's Full Name
First NameLast Name
Nominee's Email Address
example@example.com
Nominee's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nominee's Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Office/Position Being Contested
Nominator's Full Name
First NameLast Name
Nominator's Email Address
example@example.com
Candidate Statement (Why are you nominating this person?)
Eligibility Confirmation
Declaration: I confirm that the information provided is accurate to the best of my knowledge.
Should be Empty: