Alliance Nomination Form

MSMA Alliance Officer Nomination Form (Self-Nomination or Nomination)

The current MSMA Alliance Committee is in the process of filling the slate of nominated officer. This Self-Nominating Form is of assistance in the completion of this slate. If you are interested in holding an office in the MSMA Alliance, or know of a member also interested and willing to serve in an office, please complete the following form and hit submit. You can also download a fill-able word document here.

Nomination Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Previous State Experience *

Previous County Experience *

Other Pertinent Professional or Volunteer Experience *

Brief Statement about why you think the nominee or yourself would make a good candidate for this position *

Submit