Nomination Application and Consent to Serve

 
100% of survey complete.
Candidate Information:

Question Title

* 1. Full Name and Credentials (as it should appear on the ballot):

Question Title

* 2. Current Position:

Question Title

* 3. Current Employer:

Question Title

* 4. Employer Address:

Question Title

* 5. Candidate's Campaign Statement (250-300 words, including your research and leadership background to your service in a leadership role in SNRS):

Question Title

* 6. If nominated and elected by the SNRS membership, I am willing to serve this term from 2017-2019 in the office of:

By completing this form, you are authorizing SNRS Headquarters to submit your name to the SNRS Succession Planning and Nominations Committee for consideration as a candidate for office. Notification of official slate of candidates will be sent by mid-October.
REMINDER: You must provide a copy of your CV and photo to amcrosse@kellencompany.com

T