EmailMeForm
MNWT Exec Council Directory Information
This form will be used to information to be published in the MNWT Exec Council Directory.
Responses to the online form will be viewed by the MNWT Presidential Assistant. Fill in as much information as you know. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2016)
Your Email
*
Name
*
First
Last
List the name of the WT member making the motion, if it is not you (the submitter).
MNWT Exec Council Position
*
Please select
President
Administrative Vice President
Chapter Management Vice President
Programming Vice President
Membership Vice President
Financial Vice President
Extensions Director
Parliamentarian
Secretary
Presidential Assistant
Chairman of the Board
Community Connections State Program Manager
Living & Learning State Program Manager
Priority Area State Program Manager
Women's Wellness State Program Manager
Youth of Today State Program Manager
District 2 Director
District 3 Director
District 4 Director
District 5 Director
District 6 Director
District 7 Director
District 8 Director
District 10 Director
District 11 Director
Future Directions Committee Chair
Membership Management Committee Chair
Marketing Committee Chair
Key Women Committee Chair
MNWT Foundation President
Executive Director
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Chapter
*
District
*
Please select
District 2
District 3
District 4
District 5
District 6
District 7
District 8
District 10
District 11
Cell Phone
*
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If you do not have a cell phone, enter "000-000-0000"
Can people text you?
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Yes
No
Home Phone
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-
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Work Phone
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-
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-
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Theme
*
File Upload: Logo
*
Add File
Upload your logo image
Birthday
*
MM
/
DD
/
YYYY
You do not need to enter the year you were born if you do not wish to do so; if this is the case, simply type in this year
Do you wish to share information about your family?
*
Yes, I will share information about my Significant Other.
Yes, I will share information about my Child(ren).
No, thank you.
check all that apply
Significant Other
Enter only if this applies
Significant Other's Birthday
MM
/
DD
/
YYYY
You do not need to enter the year; if this is the case, simply type in this year
Anniversary Date
MM
/
DD
/
YYYY
You do not need to enter the year; if this is the case, simply type in this year
Children's Names, Ages & Birthdays
Enter only if this applies
Your address will appear on the website (including, but not limited to the CIPs, POA, the state POA's Exec Council listing, etc.) unless you OPT-OUT by checking this box.
OPT OUT
