FBN Committee Survey

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* 1. Your Name

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* 2. Name of Nominee

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* 3. If you are nominating someone else, did you talk to them about it first?

Yes

No

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* 4. Your Email Address

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* 5. Email Address of your Nominee

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* 6. Committee of Interest

NxG Committee

Membership Committee

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* 7. What time commitment are you willing to make?

1-3 hrs. per month

4-6 hrs. per month

Not Sure

Other (please specify)

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* 8. Why are you interested in joining this committee or why are you nominating this person?