2023 NPU-W Elected Representative Candidacy Form

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Email *

First Name *

Last Name
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Street address (of residence or business)
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Is the address provided a (a) residential address or a (b) business address?
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Residential

Business

Phone contact number (xxx-xxx-xxxx)
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Neighborhood of residence or business? Note: these are the City named and outlined neighborhoods within NPU-W.
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By submitting this form, I am declaring that I would like to be a 2023 NPU-W Elected Representative candidate in the October 2022 election of NPU-W Elected Representatives. *

Agree

Disagree

I agree, that if elected as an Elected Representative, I will: 1. Attend all NPU-W general meetings, and 2. Participate on at least one NPU-W Standing Committee. (NPU-W ByLaws Article 2, Section B.)

Agree

Disagree

I agree that if I fail to meet the meeting participation requirements, that I will be deemed to have resigned as an Elected Representative as provided for in NPU-W Bylaws, Article 2, Section D: Elected Representatives who, without an excused absence from the presiding person, are absent from two (2) consecutive NPU-W general meetings or committee meetings, or who are absent from three (3) general or committee meetings within a six (6) month period shall: i) be deemed to have resigned as an Elected Representative. *

Agree

Disagree

I acknowledge that I have read and agree to abide by the provisions of the NPU-W Bylaws, Article 5: Conflicts of Interest, Remuneration and Receipt of Benefit.
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Agree

Disagree

If elected as an Elected Representative I would like to be assigned to the following committee(s).
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Bylaws

Land Use and Zoning

Neighborhood Safety

Transportation

Required

If elected as an Elected Representative I would also like to be considered as a candidate to be the Chair of the following standing committee(s). Standing committee chairs shall be nominated by the committee members during their November committee meetings and then confirmed, for a period of one year by majority vote of eligible voters at the November meeting the year prior (NPU-W Bylaws, Article 3, Sec A).
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Bylaws Committee Chair

Land Use and Zoning Committee Chair

Neighborhood Safety Committee Chair

Transportation Committee Chair

Not interested in being a committee Chair

Required

A copy of your responses will be emailed to the address you provided.

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