Forms MAL Data Form

BUSINESS AND PROFESSIONAL WOMEN OF TENNESSEE , INC . ( BPW / TN ) OFFICIAL DATA FORM FOR MEMBER AT LARGE CANDIDATE FOR OFFICE
_____________________________________________________ Member at Large in good standing of the Business and Professional Women of Tennessee ( BPW / TN ), presents herself as a candidate for the office of ___________________________________________________ of the Business and Professional Women of Tennessee , Inc . ( BPW / TN ). Present business or profession ___________________________________________________________ Current BPW office , if any ________________________________________________________________ Previous State Service __________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Qualifications for Office __________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Tennessee local organization of which you were a member _____________________________________ Number of years of membership in a Tennessee BPW organization _______________________________ Date which you served as president _________________________________( for candidates for line officer )
Consent to Serve
I have carefully studied the requirements for office for which I am a candidate . Neither my job nor my membership in any other organization in any way prevents my support of the organization ’ s objectives and policies , including active support of our state legislative platform .
I agree to serve as _______________________________________, if elected . I am able to give the required time to the duties of such office and there is nothing in my health or personal affairs to prevent my serving .
Dated this ____________ day of _______________________, 20 _____.
Return form in duplicate to : Nominations Chair . [ Candiates for Executive Committee offices submit photo . Attach bio and photo for publication .]
Candidate _____________________________________________________________________________ Address ______________________________________________________________________________ Place of employment : Name & Address ______________________________________________________ ______________________________________________________________________________________ Phones : ( H ) ________________________ ( B ) _______________________ ( FAX )_____________________ Cellphone : __________________________________ E-mail : _____________________________________