FOP - NYC CORRECTION LODGE 89 (2018 ELECTION)
NOTICE OF INTENT TO RUN FOR OFFICE

Before completing this form, you should be aware that failure to faithfully discharge your duties as an officer of the FOP-NYC CORRECTION LODGE 89 may lead to removal from office.

If you are nominating someone other than yourself for a position, (1) ALL SECTIONS OF THE APPLICATION MUST BE COMPLETED (2) LETTER OF INTENT from the candidate MUST be received by COB 5/31/18. (3) NOMINATION DEADLINE IS 5/31/18

All correspondence must be addressed to: THE SECRETARY, FOP-NYC CORRECTION LODGE 89. P.O. BOX 690701, E. ELMHURST, NY 11369.

Email address *
YOUR FIRST NAME *
Your answer
YOUR LAST NAME *
Your answer
NAME OF CANDIDATE (if you are nominating someone other than yourself)
Your answer
IF YOU ARE NOMINATING SOMEONE ELSE, HAVE YOU SPOKEN TO THE INDIVIDUAL TO MAKE SURE HE / SHE IS INTERESTED IN THE POSITION?
IF YOU ANSWER NO, STOP!, CONTACT THE INDIVIDUAL FOR HIS / HER CONSENT BEFORE PROCEEDING WITH THIS FORM ?
YOUR MEMBERSHIP # *
Your answer
YOUR CANDIDATE'S MEMBERSHIP #
Your answer
HOW LONG HAVE YOU BEEN A MEMBER? *
Your answer
HOW LONG HAS YOUR NOMINEE BEEN A MEMBER?
Your answer
HAS YOUR MEMBERSHIP BEEN CANCELED / REVOKED WITHIN THE LAST 2 YEARS? *
IF YES TO THE ABOVE QUESTION, PLEASE EXPLAIN
Your answer
HAS YOUR CANDIDATE'S MEMBERSHIP BEEN CANCELED / REVOKED WITHIN THE LAST 2 YEARS?
IF YES TO THE ABOVE QUESTION, PLEASE EXPLAIN
Your answer
HAS YOUR MEMBERSHIP BEEN REINSTATED? *
HAS YOUR CANDIDATE'S MEMBERSHIP BEEN REINSTATED?
ARE YOU CURRENTLY IN "GOOD STANDING" WITH THE LODGE? *
IS YOUR CANDIDATE CURRENTLY IN "GOOD STANDING" WITH THE LODGE?
HAVE YOU ATTENDED AT LEAST 70% OF THE MEETING WITHIN THE LAST 12 MONTHS ? *
HAS YOUR CANDIDATE ATTENDED AT LEAST 70% OF THE MEETING WITHIN THE LAST 12 MONTHS ?
YOUR MAILING ADDRESS *
Your answer
YOUR CITY *
Your answer
YOUR STATE *
Your answer
YOUR ZIP CODE *
Your answer
YOUR CONTACT # *
Your answer
YOUR CANDIDATE'S MAILING ADDRESS
Your answer
YOUR CANDIDATE'S CITY
Your answer
YOUR CANDIDATE'S STATE
Your answer
YOUR CANDIDATE'S CONTACT #
Your answer
IF ELECTED, WILL YOU BE ABLE TO ATTEND THE MEETINGS? (REQUIREMENT FOR THE EXEC. BOARD POSITIONS) *
IF YOUR CANDIDATE IS ELECTED, WILL HE / SHE BE ABLE TO ATTEND THE MEETINGS? (Requirement for the Executive Board positions)
POSITION OF INTEREST *
ELECTION WILL TAKE PLACE DURING THE JUNE 2018 MEETING (Date and location to be announced), WILL YOU BE ABLE TO ATTEND? *
ELECTION WILL TAKE PLACE DURING JUNE 2018 MEETING (Date and location to be announced), WILL YOUR CANDIDATE BE ABLE TO ATTEND?
Please be aware that if elected, failure to faithfully discharge your duties as officer of FOP-NYC CORRECTION LODGE 89 may lead to your removal from office *
FAILURE TO COMPLETE ALL APPLICABLE SECTION OF THIS FORM WILL MAKE YOUR NOMINATION NULL & VOID. By inserting the date on this form, I understand the contents of this application and promise to abide by the FOP-NYC CORRECTION LODGE 89 Rules & Regulations governing this election. *
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