MCA Application for Nomination
APPLICATION for BOARD of DIRECTORS NOMINATION
Email address
Name:
Your answer
Address:
Your answer
City:
Your answer
Zip:
Your answer
Neighborhood/Development Name:
Your answer
McLean area resident (# yrs):
Your answer
Phone (H):
Your answer
Phone (W):
Your answer
Fax (H):
Your answer
Fax (W):
Your answer
E-Mail:
Your answer
Are you currently:
Are you applying for:
If you are applying for an MCA Officer what do you want to be :
If you are applying for MCA Director please specify which type:
NEIGHBORHOOD REPRESENTATIVE
(To be completed by the President of your association) Limited to one nomination.
Name of Association:
Your answer
Number of homes covered by the Association:
Your answer
Was a association meeting in the last year attended by 15 or more people?
Designated Alternate:
Your answer
Phone (H):
Your answer
Phone (W):
Your answer
E-mail:
Your answer
President’s Signature (Email approval will suffice):
Your answer
Print name (Association President):
Your answer
Address:
Your answer
City:
Your answer
Zip:
Your answer
Phone (H):
Your answer
Phone (W):
Your answer
E-Mail:
Your answer
EXPERIENCE
(List current or past activity, committee service, etc., and approximate dates):
MCA/MCF EXPERIENCE
Your answer
OTHER EXPERIENCE (Vocational, Educational, Philanthropic, Civic, etc., and approximate dates) Please do not send resumes.
Your answer
MCA COMMITTEE PREFERENCE (Select at least one standing committee that you will participate in. Also, please Indicate if you are interested in serving as chair, or co-chair or vice-chair of the committee; vice-chairs serve in the absence of the chair.)
Applicants/nominees for MCA positions agree by signing this form that they will attend all scheduled MCA meetings, unless granted an excused absence, and actively participate on at least one committee, most of which meet monthly. The applicant/nominee certifies that he/she is a current member in good standing of the MCA and currently residesin the MCA-defined area, designated as the area bounded by the Potomac River, the Arlington County line, the Falls Church City line, Route 7, the Dulles Access Road to Difficult Run and along Difficult Run to the Potomac River. In applying for an MCA Board of Directors' position, the applicant/nominee agrees to abide by the Bylaws and Policies/Procedures of the organization. (The documents will be provided upon request, prior to application signature).
SIGNATURE:
Your answer
DATE:
MM
/
DD
/
YYYY
Click Submit below or print and send your application for the MCA Board to the McLean Citizens Association, PO Box 273, McLean, VA22101-0273. Applications must be postmarked no later than March 12, 2017.
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