2012 Call for Nominations Form

EBAA BOARD OF DIRECTORS NOMINATION FORM
CHAIR ELECT
Please type directly into the document, print and email or fax completed application. Nominations not
accompanied by a candidate photo will be considered incomplete.
Name of Candidate: __________________________________________________________
Position and Eye Bank: ________________________________________________________
Phone: ___________________________
Email: _________________________________
Position Nominated For: ______________________________________________________
Candidate Biography (limit 250 words):
Personal Statement (limit 250 words):
Sponsor’s Name: _______________________________________________________________
Sponsor’s Phone: ________________________Sponsor's Email: _________________________
Mail, fax or e-mail all nominations by March 29, 2012 to:
Jason Woody
c/o EBAA
1015 18th Street, NW, Suite 1010
Washington, DC 20036
Phone: 202.775.4999
Fax: 202.429.6036
For questions, email: jwoody@lionseyeinstitute.org