Accept/Decline Nomination Form

AFSA Governing Board Election Accept/Decline Nomination Form

Please note that a red asterisk indicates a field that must be filled or a question that must be answered in order for the form to be submitted.

Do you accept the nomination? *

Yes

Your Name *

Position for Which You Have Been Nominated *

Your Work Email

Your Personal Email *

Your Name (as it should appear on ballot and election materials) *

Your Employment Status as of September 15, 2019 *

Active-Duty

Retired

Position for Which You Have Been Nominated *

Your Agency *

Your Work Email

Your Personal Email *

Your Phone Number *

Are you an AFSA member? *

Yes

Dues Payment Method *

Annual

Deduction

Lifetime

Your Current Position to ensure eligibility, including no conflict of interest with official duties. *

Your Prior Position to ensure eligibility, including no conflict of interest with official duties. *

Your Position as of September 15, 2019 to ensure eligibility, including no conflict of interest with official duties. *

Your Home Address as of September 15, 2019 *

Are you running as part of a slate? *

Yes

Please indicate your slate. *

Do you wish to be part of a slate? *

Yes

Please indicate your desired slate. *

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question * 19 + 0 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.