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Board of Directors Nomination Form
For consideration to the 2024-2025 Board of Directors slate, please submit this form by
March 4, 2024.
Questions should be directed to Erin Klug, WLAM Immediate Past President, at
eklug@patentco.com
.
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* Indicates required question
Email
*
Your email
Name of Candidate:
*
Your answer
Board Position(s) of Interest
*
Director
President-Elect
Vice President
Treasurer
Secretary
Required
Current Work Position (include title, name, and address of institution):
*
Your answer
Telephone:
*
Your answer
Educational Preparation (include degree, date, place):
*
Your answer
Past Participation in WLAM:
*
Your answer
Qualifications for Office:
*
Your answer
WLAM is committed to ensuring a board that represents diverse backgrounds and opinions. What will be the contribution of the nominee be to furthering this mission and to promoting diversity, equity and inclusion?
*
Your answer
State Briefly why the nominee wishes to run for office
*
Your answer
Name of Nominator: (indicate "self" if self-nominating)
*
Your answer
Nominator's Phone:
Your answer
Nominator's Email:
Your answer
A copy of your responses will be emailed to the address you provided.
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