NOMINATION FORM

Nomination deadline:  5pm on Friday, April 14, 2023

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* 1. Nominee's Name
(only self-nominations are accepted)

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* 2. Nominee's discipline

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* 3. GWC Email

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* 4. Status

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* 5. Select the position you wish to represent:

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* 6. I confirm meeting the eligibility requirement: Any full-time faculty member who has served on IPD for at least two years within the past four years and who remains a full-time faculty member during their term is eligible.

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* 7. Statement of Interest
Please write a BRIEF (2-3 sentences) statement explaining your reason for wanting to serve. May include accomplishments, expectations, goals, etc. as they relate to the committee's mission and charge. Statements of Interest are reviewed as part of the election process.

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