|
North Carolina Mothers of
Multiples
OFFICER
APPLICATION FORM
|
Kim Koontz wickedwitch@ptmc.net 246 Beech Tree Ln. Lexington, NC 27295 (336) 787-2278 |
NAME
__________________________________ DATE OF APPLICATION________________
ADDRESS___________________________________________________________________
TELEPHONE:
DAYTIME_________________________ EVENING______________________
CLUB
AFFILIATION___________________________________________________________
ADDRESS___________________________________________________________________
NAME OF CLUB
PRESIDENT____________________________________________________
ADDRESS___________________________________________________________________
TELEPHONE______________________________
POSITION APPLIED
FOR______________________________________________________
REASON YOU ARE SEEKING THIS POSITION:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Signature of Applicant_____________________________________
Please complete one:
__________I am placing myself in nomination
__________I am being nominated
by____________________________________________
(Signature of person making
nomination)
Submit to the Nominating
chairman via email before the May 15th deadline. This form must be accompanied by a Verification
of Applicant Qualifications Form, completed and signed by your local club
president.
NCMOMs November 1990