2021 UEC Member Nomination Form
Please fill in the below information for your nominee to serve on the ALS UEC

Please note: upon receiving a nomination, we will request a short bio and a 1-2 paragraph statement from the nominee describing their envisioned goals as a UEC member. This text will be displayed in the election ballot system. You can find examples of these statements: http://alsuec.org/new/index.php/als-uec-elections-2019/
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Nominee First Name *
Nominee Last Name *
Nominee Email Address *
Nominee Institution (for LBNL, also provide division) *
Discipline *
Career Level *
Field of Expertise
Your First Name (Nominator) *
Your Last Name (Nominator) *
Your Email Address (Nominator) *
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