Position nominated for: Vice-President ______ Treasurer _______ Director at Large _______ Personal information of nominee: Full Name: _______________________________ Membership #: ________________ Full Address: ____________________________________________________________ Telephone: __________________ Email: _______________________________ Consent by the Nominee: I, _____________________________ , hereby allow my name to stand for nomination. Signature: ___________________________ Date: _________________ Nominee Profile: Provide a brief summary of your involvement in triathlon, why you want to be a Triathlon Board member, and the related skill set you would bring. Conflict of Interest Disclosure Form Committee or Program Area Positions / Involvement: _______________________________ Disclosure of conflicts (real or perceived): Please provide details of the situation.
Position nominated for: Vice-President ______ Treasurer _______ Director at Large _______ Personal information of nominee: Full Name: _______________________________ Membership #: ________________ Full Address: ____________________________________________________________ Telephone: __________________ Email: _______________________________ Consent by the Nominee: I, _____________________________ , hereby allow my name to stand for nomination. Signature: ___________________________ Date: _________________ Nominee Profile: Provide a brief summary of your involvement in triathlon, why you want to be a Triathlon Board member, and the related skill set you would bring. Conflict of Interest Disclosure Form Committee or Program Area Positions / Involvement: _______________________________ Disclosure of conflicts (real or perceived): Please provide details of the situation.
2018-19-Board-Nomination-Form.docx