Nomination form

Help select the people who will represent you and your professional concerns on the ACCP Board of Directors.  Nominate yourself or someone else for any of these positions.  Nominations must be received at the ACCP office no later than May 31, 2017.

Please mail, fax, or email this form to ACCP.  Mail to: ACCP, 5404 S. Taft Ct. Littleton, CO  80127; Fax: (303) 998-2956; email: scp@corrdocs.org

1.  NOMINEE CONTACT INFORMATION

Name of nominee:

Professional designation(s):

Job title:

Employer:

Address:

City, State, Zip:

Telephone:

Email:

2.  Circle the position for which this person is being nominated:

President-Elect        Secretary        Treasurer        Director (4-year term)        Director (2-year term)

3.  Why do you think this person meets the criteria for Board service?

 

4.  YOUR CONTACT INFORMATION:

Your name:

Your professional designation(s):

Your job title:

Your employer:

Your address:

Your city, state, zip:

Your telephone:

Your email:

THANK YOU for helping select ACCP leaders!