BOD Submission Form

2017 Executive Board Candidate Form

Name *

First

Last

Email *

Phone Number *

Please confirm that there is no material conflict of interest that would disqualify you from holding the intended office, such as concurrently serving on the RWA Board or another chapter Board.

Will you be on the Executive BOD or General BOD for another chapter in 2017? *

No Yes, Executive BOD Yes, General BOD

If Yes, what chapter and what position? *

2. Please select one below. *

Candidate Bio (100 Words Max) *

Submit