Note:
Complete the form below by noon on May 10, 2019. Late and incomplete submissions won't be considered.

Question Title

* 1. Candidate Name:

Question Title

* 2. Address:

Question Title

* 3. City:

Question Title

* 4. Zip Code:

Question Title

* 5. Home Phone:

Question Title

* 6. Cell Phone: 

Question Title

* 7. Business Phone: 

Question Title

* 8. Email:

Question Title

* 9. Nominated by the following district/ISD/RESA board of education (attach letter/minutes below):

Question Title

* 10. Upload nomination letter/minutes (Word or PDF file):

PDF, DOCX, DOC file types only.
Choose File

Question Title

* 11. County district is located in:

Question Title

* 12. Years of service on this board:

Question Title

* 13. Offices held (check all that apply):

Question Title

* 14. Years of service on another school board (enter N/A if not applicable):

Question Title

* 15. Which district?

Question Title

* 16. Offices held (check all that apply):

Question Title

* 17. MASB Certification (check all that candidate has earned):

*NOTE: MASB Bylaws Article VIII – Section 5. Qualifications. “Each Director of the Association shall have served as a qualified trustee of an Active or Academy member board of education for at least one year and have completed the Fundamentals of School Board Service course (CBA 101) at the time of his or her nomination to office.” Consideration will also be given to participation in MASB events and the overall makeup of the Board as a reflection of the MASB membership.

Question Title

* 18. Candidate to represent the following Region or Group:

Question Title

* 19. Election Statement: Please state your qualifications and why you wish to serve on the MASB Board of Directors. The election statement must not exceed 400 words; additional words will be deleted.

Question Title

* 20. Please provide a professional color photo for MASB use. Photos of poor quality won't be used (jpg preferred).

GIF, JPEG, JPG file types only.
Choose File

T