Nominations

Form

2006 San Jose District Nominations

The San Jose District is always on the look out for active members to be involved with the many committees and offices that make the San Jose District, CPTA and APTA strong professional organizations.

If you or someone you know would be suited to serve on a committee or run for an office, submit the form below.

If you have further questions, please contact Judy Sebring
 
 

What is your name?

What is the name of your nominee?

Where does the nominee work? (Facility name)

What is the nominee's phone number? (Please include area code.)

Have you used this form before?
Yes, I have used service before
No, I have not used this service

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