Nomination to FLIC’s Board of Directors 2022 (for Term 2022-2023)

This form needs to be filled out by the candidate that you are nominating.

This nomination form takes about 20-30 minutes to fully fill out. If you cannot dedicate this time now, it is best for you to revisit this link when you are ready to fully fill it out.
All candidates must submit this form by September 7, 2022 to allow for proper translation of the ballot. 
Although nominations from the floor are allowed, according to our bylaws, on Day 1 of congress.

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Email *
1. First Name of the Nominee *
2. Last Name of the Nominee *
3. Phone # of the Nominee *
4. Name of the FLIC Member Organization that you are a member of? *
5. Are you authorized by the organization in #4 to serve on FLIC's Board of Directors? Please explain: *
6. Mailing address of the organization that this nominee represents
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