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Summary: NOMINATION FORM
2010-11 MOMS ASSOCIATION BOARD OF DIRECTORS
Name _______________________________________________________________
Address _______________________City State Zip
County __________________________
Phone Number/s ___________________ E-Mail Address/es ____________________
In order to be eligible to serve on the Board of Directors, I agree that I must have a student enrolled
at the University of Illinois at Urbana-Champaign at the time the Moms Association Board of
Directors approves my nomination.
Student(s) Name(s): College: Date(s) of Graduation:
Indicate your participation in Moms Association events.
Football Cookie sales volunteer Moms Weekend volunteer
Attended Illini Parents 101 Spring Retreat
Summer Registration volunteer County Representative
Latino Family Visit Day Presidents Award Program
Orange & Blue Days volunteer Other (specify)
Please use the space below to tell the committee something about yourself and why you are
interested in serving on the Board.
_______________________________________________________________________________
_______________________________________________________________________________
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