EmailMe Form - NASW-VI Leadership Nomination Form

CONTACT/BACKGROUND INFORMATION
NASW Member ID

If you need your NASW Member ID, please contact the NASW-VI Chapter Office at 1-800-352-6279. You must be a current member to be on the Chapter Leadership elections ballot. *
Name: Please include your credentials. *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Preferred Phone *
### - ### - ####
Alternate Phone
### - ### - ####
Email *
POSITION INTEREST
Position Sought: *
President (Two-Year Term)
Secretary (Two-Year Term)
St. Croix District Chair (Two-Year Term)
Members at Large (1) (Two-Year-Term)
Student Representative (One-Year Term
Please outline your leadership experience in previous positions held with NASW-VI and / or other volunteer organizations. *
Please provide a one paragraph position statement for the position for which you are running. *
Please Upload a Current Photo for the Election Ballot. Files accepted: .pdf; .jpg and jpeg. Please name your file LastNameFirstName. *
Please Upload a Current Resume / CV as a .pdf File.
Please name your file: LastNameFirstName. *
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