Board Nomination Form – Missouri Animal Control Association

MACA Board Nomination Form

Board members are voted into office at the General Board Business Meeting.

During the Annual Training Conference.
If you would like to serve, please submit a nomination form.

Board position to be nominated for:

Date

Nominee's Name

Nominee's Address

Nominee's City and State

Nominee's Zip Code

Nominee's Email

Nominee's Phone Number

Nominees Duty Position:

Number of years as a MACA member:

Length of time the nominee has worked in an animal welfare position:

Is the Nominee willing and able to commit to attending board meetings as necessary to conduct the Association’s business, and to attend MACA Training Venues?animal care and control/welfare?

Has the nominee ever been convicted of an animal law violation or felony of any sort?

If yes, please explain:

Nominee's Agency

Nominee's Agency Address

City and State

Zip Code

Nominee's Supervisor's Name

Supervisors Title:

Supervisor's Email Address

ACFA License#

In the space below, please explain the nominee’s educational background, experience, qualifications and any other information stating why he or she would be a good candidate for an Executive Board position.