THIS FORM MUST BE RECEIVED BY THE CHAIRMAN OF THE NOMINATION COMMITTEE NO LATER THAN OCTOBER 5, 2017 TO BE CONSIDERED. EMAIL TO NOMINATION FORM TO REGGIEARMSTRONG@COMCAST.NET 

Name *
Name
ARE YOU CURRENTLY AFFILIATED WITH THE UNIVERSITY OF MICHIGAN? *
ARE YOU A GRADUATE OF THE UNIVERSITY OF MICHIGAN? *
ARE YOU A DUES-PAYING MEMBER OF THE UNIVERSITY OF MICHIGAN ALUMNI ASSOCIATION? *
PLEASE PROVIDE INFORMATION ABOUT YOUR WORK EXPERIENCE, WHICH YOU BELIEVE IS RELEVANT TO YOUR QUALIFICATIONS TO SERVE AS A BOARD MEMBER
PLEASE PROVIDE INFORMATION ABOUT ANY OTHER EXPERIENCE, WHICH YOU BELIEVE IS RELEVANT TO YOUR QUALIFICATIONS TO SERVE AS A BOARD MEMBER
PLEASE CHECK THE COMMITTEE(S) ON WHICH YOU WOULD LIKE TO SERVE *
I HEREBY CERTIFY THAT AT THE PRESENT TIME, I KNOW OF NO REASON THAT, IF ELECTED, I WOULD NOT BE AVAILABLE TO ATTEND AT LEAST MONTHLY MEETINGS OF THE BOARD DURING EACH FISCAL YEAR. *
Date *
Date