LWVLC, Jean Oxley Nomination Form Question Title * 1. Nominee _______________________________________________________________________________ Question Title * 2. Nominee’s home address________________________________________________________________________ Question Title * 3. Nominee’s Workplace and Position_______________________________________________________________ Question Title * 4. Nominee’s Phone Numer_______________________________________________________________ Question Title * 5. Your Name _______________________________________________________________ Question Title * 6. Your Address___________________________________________________________________________________ Question Title * 7. Your Email & Phone Number ___________________________________________________________________________________ Question Title * 8. Please email the nomination and 1 page write up to both jeanmcmenimen@gmail.com and breanna.oxley@gmail.com or send to P.O. Box 2422 Cedar Rapids, Iowa 52406 Question Title * 9. Nomination forms and write-ups are due by Friday, April 30th by 5 pm Done