Board Nomination: Director At-Large 2023

As a member of BCDHA in good standing, I,(Required)

First Last

Of (City or Town)(Required)

City Province

Phone(Required)

Enter your phone number here

Email(Required)

Enter your email address here

Am nominating, for election as a Board Member for the position of Northern Region:(Required)

Myself

Another candidate

Name of other candidate (please fill even if you are self-nominating)(Required)

First Last

Please enter the name of the person you're nominating .

Candidate Phone (if known to you)

Candidate Email(Required)

Dated at (City or Town)(Required)

City Province

Date(Required)

Picture of the Nominee (500x500 pixel square requested)(Required)

Max. file size: 256 MB.

Please ensure that your photo is at least 500x500 pixels square. Larger photos are fine but may be edited to fit our format. Please email bcdha@bcdha.com with any questions, we're happy to help.

Short Bio(Required)

Please include a short bio (between 250 and 400 words) outlining why you, or the nominee, are interested in being part of the BCDHA Board.

Signature(Required)

Please type your full name (first and last) here to validate this nomination