Board Nomination Form

Forms are due Dec. 6, 2022 at 5:00 p.m.

Name(Required)

First Last

Email(Required)

Phone(Required)

Preferred Mailing Address

Your Address(Required)

Street Address Address Line 2 City State ZIP Code

Assistant/Administrator Name

First Last

Assistant/Administrator Email

Assistant/Administrator Phone

Are you being appointed by your jurisdiction?(Required)

Yes

Name of represented entity

Upload formal document if required by your jurisdiction.

Max. file size: 1 MB.

Do you wish to be considered for an officer position? (Note: Any person may request consideration for more than one office. Any person who is not recommended for the requested position on the Board of Directors will automatically be considered for another position on the OKI Board of Directors.)

Officer position desired:

President

First Vice President

Second Vice President

Treasurer

Executive Committee Alternates

If the jurisdiction you represent is on the executive committee (jurisdictions on the executive committee are listed below in the dropdown menu), you are permitted to designate an alternate who can vote on your behalf at Executive Committee meetings only. Select your jurisdiction if applicable:

Alternate Name

First Last

Alternate Email

Alternate Phone