Nomination Form for District 9 Office
CANDIDATES SERVING THE 2024-2026 BIENNIUM
Nominations close June 1, 2023

HEADSHOT: Please send your name, candidate position, and headshot to: District9nominating@gmail.com and continue completing this form.

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Email *
Name of Candidate *
First name, last name
Address *
123 Example St., City, State, Zip Code
Email Address *
Example@Example.com
Phone Number *
(###) ### - ####
Can this phone number receive text messages? *
(###) ### - ####
Which Zonta Club do you belong to? *
Zonta Club of Anytown
How many years have you been a Zontian? *
Business/Professional Information
Provide most recent
Current Company/Organization or retired from:
Nature of business
Position/Title
Number of years in most recent position
Responsibilities of position
Zonta and community service
Please list all past positions held at the club, area, district, and international level, including dates. *
What other civic, community or professional organizations have you participated in outside of Zonta during the past five years? Do you have any future commitments during the 2024-2026 biennium? *
Question for nominees of Officers (Governor, Lt. Governor, Treasurer, Area Directors)
What special skills and knowledge do you bring to this position? (Maximum 100 words)
Question for nominees of Nominating Committee
How do you intend to improve the efforts of the committee to encourage leadership with our membership? (Maximum 100 words)
Signatories to Nomination
Note that in the following section there are two names required for the nomination form to be accepted - the nominee and the nominator. The nominator must be a club represented by its president OR a Zonta club member other than the nominee. To be able to nominate, clubs or club members must be in good standing.
The above-named Zonta member has consented to the submission of their name for the nomination to the office of (please check one position below), has agreed to serve if elected, meets the prerequisites, and is qualified in accordance with the Zonta International Bylaws.   *
NOMINATOR
Choose Option 1 or Option 2
OPTION 1 - Individual nominator name
By printing your individual nominator's name below, the individual as nominator is electronically signing this document in support of the aforementioned candidate.
Nominator's club
Nominator's email
Date
MM
/
DD
/
YYYY
OPTION 2 - Club nominator president's name
By printing your president's name below, the president as nominator is electronically signing this document in support of the aforementioned candidate.
President's club
Club president's email
Date
MM
/
DD
/
YYYY
I CONSENT to have my name submitted for consideration for the stated position on this form. 
For a position on the District 9 Board, I have read Section 7 (Duties of Officers) and Section 9 (District Board) of the Zonta International District 9 Bylaws.
I understand the duties, responsibilities and time commitment of the role for which I am being nominated.
The information provided in this Nomination Form is accurate and correct and no significant information has been omitted.
I understand that any incorrect, misleading or omitted information may disqualify me from office.
 *
I have read the above and confirm:
I have read and will abide by the Zonta International Campaigning Policy.
I will uphold and abide by the Bylaws and Rules of Procedure of Zonta International District 9 and decisions of the Board of Directors.
If elected, I will carry out the duties and responsibilities of the position and conduct myself in an appropriate manner.
If, due to unforeseen circumstances, I become unable to run for the stated position, I undertake to notify the District 9 Nominating Committee Chair immediately.
 *
Today's Date: *
MM
/
DD
/
YYYY
By printing your name below, you are signing this form electronically. *
PHOTOGRAPH
In order for your submission to be complete, you must submit a complete form and a photograph (headshot) preferably 1 megabyte in JPEG format by June 1, 2023. Your photograph file name should contain your first and last name. Email to: district9nominating@gmail.com
A copy of your responses will be emailed to the address you provided.
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