Home › Get Involved Get Involved Nominations Agreement Form Nominations Agreement Form Name Organization Title Address Telephone Email I request to serve on: Energy Education Council (EEC)/Safe Electricity Board of Directors EEC/Safe Electricity Advisory Board I would be willing to serve as Chair or Officer Yes No Please provide the following information: Number of years in field Areas of specialty Areas of interest If useful to include, what was your occupation prior to this profession or trade? Leadership experience Have you ever served on other EEC/Safe Electricity boards? Yes No If yes, please explain, including group(s), service dates and any details you may wish to share: What do you feel are the major challenges facing EEC/Safe Electricity? What suggestions do you have to respond to these challenges? Are you aware that as an EEC/Safe Electricity Board Member, you would not just be in a ceremonial position, but one with responsibilities and obligations? Yes No As an officer or board member, you will be representing EEC/Safe Electricity. Will you support positions taken by the Board of Directors, even if you opposed the positions when they were being considered and debated by the Board of Directors? Yes No In your own words, please describe your perception of the role of the position for which you desire to serve and the reasons you feel you are best qualified to do so Are you willing to sign an annual conflict of interest statement? Yes No Do you have your employer’s support or personal means to cover necessary travel expenses? Yes No Please list any involvement in prior and current organizations as well as position held (work and/or volunteer related). Organization, dates served, position Organization, dates served, position Organization, dates served, position Organization, dates served, position Date Signature Submit If you are human, leave this field blank. Δ
