WEAC-Retired Executive Committee Nomination Form - Wisconsin Education Association Council

Form must be received in the office of the WEAC Executive Director by January 15, 2021, regardless of postmark date.

If this form is printed, it must be received in the office of the WEAC Executive Director by January 15, 2021, regardless of postmark date. WEAC Executive Director PO Box 8003 Madison, WI 53708-8003

This is a nomination for the office of: (Check the appropriate box)

President
Vice President
Secretary
Treasurer
At-Large Representative
Membership Coordinator

Name of Candidate

First Last

Candidate's Address

Street Address Address Line 2 City State Zip Code

Candidate's Email Address

Candidate's Member Number

Candidate's Phone (with area code)

Please Note: *If elected, I am willing to serve a three-year term of office beginning September 1, 2021, for the WEAC-Retired Executive Committee position checked above. *I understand that no portion of dues money collected at the local, state, or national level may be used to promote my candidacy for the WEAC-Retired Executive Committee position.

Brief statement (not to exceed 200 words) setting forth candidate's qualifications. Words in excess of 200 WILL NOT be included in candidate's published statement.

For self-nomination only: By entering name on this field, I am electronically signing my application.