NIRSC Board Nomination--2024

Nominee's First Name: *
Nominee's Last Name: *
Nominee's Professional Designations:
Nominee's Employer: *
Nominee's Email: *
Nominee's Phone Number: *
How long has the nominee been a member of the NIRSC?: *
Why would the nominee be a good candidate to serve on the NIRSC Board?:
What would be a goal of the nominee in serving on the NIRSC Board?:
Please submit a brief introduction of the nominee. :
Please upload resume for the nominee. :
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Please upload headshot of the nominee. :
(Valid File Types: bmp,csv,doc,docx,eps,gif,jpeg,jpg,mfp,pdf,png,ppt,pptx,rft,swf,tif,txt,xls,xlsx | Maximum File Size : 1.0 MB)