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* 1. Contact Information

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* 2. ASCE-EWRI Member ID Number

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* 3. Educational Background

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* 4. Please describe and past or current committee and/or council participation

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* 5. Please list any professional licenses held

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* 6. Statement of Personal Qualification & Vision for EWRI

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* 7. Signature of Nominee (by typing your name you verify that the information submitted in this survey is true)

Statement of Commitment
The foregoing is presented to the EWRI Governing Board Nominations & Elections Committee for consideration for the Vice President position on the EWRI Governing Board. I fully understand the responsibilities and am willing to serve, if appointed.

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* 8. If nominating someone other than yourself, please fill out the below
information

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