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Board of Directors Nomination Form
This Section to Be Completed By Nominator.
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Today's Date
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MM
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DD
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YYYY
Full Name
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Your answer
Address
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Your answer
City/State/Zip Code
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Your answer
Best Telephone Number
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Your answer
Are you an active NAMI LCH Member?
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Yes
No
Full name of the person you are nominating.
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Your answer
Please indicate your relationship to the individual you are nominating (check all that apply).
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Friend
Colleague
Relative
Other:
Required
Please explain why you believe the individual you are nominating is a good candidate for the NAMI LCH Board of Directors and why you are nominating this person.
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Your answer
Please explain any direct involvement this individual has had with mental illness, the mental health system or NAMI on the local or state level.
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Your answer
Please share with the Nominating Committee any skill sets or relevant information that you believe would make this person a good candidate for the Board of Directors.
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Your answer
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