TEA and NEA Delegate Nomination Form

This form is designed to gather nominations of those interested in serving as delegates to the NEA Representative Assembly and the TEA Representative Assembly. The collector will be deactivated automatically at 11:59 p.m. Central Standard Time on Thursday, February 8, 2018. a separate nomination form may be used for additional TEA delegate nominations should all potential delegate slots not be filled.

* Please provide the following personal information

* What is your primary school/work location?

* Phone numbers (please include area code)

* Please indicate the election(s) in which you intend to run. (Mark all that apply.)

* If applicable, indicate the badge name for your NEA delegate badge.

* Have you ever attended an NEA Representative Assembly?

* How would you describe your position?

* Indicate the Association position you hold. (This information will be included on the NEA delegate ballot subject to verification.)

* What is your gender?

* My race/ethnic background is:
(Mark all that apply.)

* By submitting this form I am acknowledging I am an MNEA member in good standing. All of the information provided above is accurate to the best of my knowledge.

* Please enter your employee ID number and your NEA Member ID Number in the boxes below. You can find your NEA ID on your membership card or the mailing label of your TEAch magazine or NEA Today magazine. These two numbers will serve as your digital signature.

INCORRECT DATA IN THESE BLOCKS WILL INVALIDATE YOUR SIGNATURE AND RENDER YOUR SUBMISSION VOID.

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