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* 1. I am self-nominating for the following position:

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* 2. I am nominating the following person for this position:

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* 3. Please provide any current or past Board experience.

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* 4. What are your current association affiliations (include leadership positions)

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* 5. Please describe in detail some of your greatest strengths and weaknesses.

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* 6. What do you feel is essential to the continued growth and success of AMPs?

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* 7. Please detail your interest in joining the AMPs Board of Directors.

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* 8. Please provide your contact information:

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