UCAAA Board of Directors Nomination Form

Individuals are allowed to self-nominate.

First Name: Required Field

Last Name: Required Field

Primary E-mail: Required Field

Cell Number:

Does the nominee have prior knowledge of this nomination? Required Field

First Name: Required Field

Last Name: Required Field

Maiden Name:

Nominee Email:

Address:

City:

State:

Zip:

Cell Phone:

Employer:

Title or Position:

UCA Degrees and Class Years:

Involvement while a STUDENT at UCA (organizations, teams, etc.):

Involvement with UCA since Graduation:

Please tell us about the nominee and what makes the nominee an excellent candidate.

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