Complete the following form to submit your online nomination to our Board of Directors Governance Committee Name Please Select * I am nominating myself I am nominating another individual First Name (Nominator) Last Name (Nominator) Phone Number (Nominator) Email Address (Nominator) First Name (Nominee) * Last Name (Nominee) * Phone Number (Nominee) * Email Address (Nominee) * Does the Nominee Reside in Cape Breton? * Yes No If Yes, Identify Your Region in Which You Reside * Does the Nominee Have Board Experience? * Yes No If Yes, Which Board(s) * Record a Short Statement Describing Why the Nominee Should be Considered as a Worthy Member of Basketball Cape Breton Board of Directors * Please Select * I agree to let my name stand for nomination to the Basketball Cape Breton Board of Directors. I agree to have the Governance Committee contact the candidate I have nominated and disclose my name as the source of the nomination Record Your Own Name (To Serve as Signature/Acknowledgement)
