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Nomination By Petition Questionnaire (2010 Election) Part 1

Personal Information

Name: VyStar Member#:
Member Since: Email Address:
Social Security #: Date of Birth:
Employer: Position:
Business Phone #: Home Phone #:
Home Address: City:
State: ZIP Code:

Personal Background
I hereby apply for nomination by petition to the Board of Directors.

Education:
Experience that you feel would qualify you to serve on the Board of Directors:
Civic activities and professional societies:
Why would you like to be a nominee for the Board of Directors?

 

 

2010 Application for nomination by petition to the Board of Directors (Part II)

Biographical Sketch
  1. Enter your name and title as you would like it to read in official publications and on the ballot.
    Name: Title:

  2. Outline your qualifications to serve on the Board of Directors. This information may be used in official publications and on the ballot, if you are nominated. Biographical data for inclusion in the election ballot may include only qualifications and biographical information. Campaign statements or statements of philosophy may not be included. The credit union reserves the right to verify and edit biographical data. This biographical sketch must contain not more than 75 words.

    Words remaining: