Nominee Information
First Name*
Last Name*
Title*
Organization*
Date of Birth*
Political Party*	Please Select Democrat Republican Green Independent Other
Status	Elected Appointed Other
Business Address*
City*
State*
Zip Code*
Email*
Business Phone
Business Fax
Personal/Cell Phone
What special background, qualitites, or experience does this nominee have that would make him or her a good ACYPL delegate
Qualities
Nominator Information
First Name:*
Last Name:*
Email:*
Title:
Organization:
Business Address:
City:
State:
Zip Code:
Business Phone:
Business Fax:
Personal/Cell Phone:
What is the Best way for ACYPL to contact you.
delegate to
Year
Alumni Council Membership	Annual Lifetime
Other ACYPL Involvement
Please attach a copy of either the nominee’s resume or bio.
Resume*
Bio