KAGE District Representative Nomination Form

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Thank you for recommending either yourself or another person for a position as a KAGE District Representative.

*Please make sure that you have contacted the person that you are nominating and that he/she is aware of your nomination.

*Keep in mind that the nominated person must be a current KAGE Member and have regular attendance and "good standing" as a Board Member.

Email *

Your Name (First, Last) *

Name of Person that You are Nominating or Write "Self Nomination" *

Email and/or phone number of the Person that you are Nominating or your email/phone number, if Self Nomination *

Congressional District of the Nominee *

A copy of your responses will be emailed to the address you provided.

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