SEM Board Nomination Form

All nominations must be submitted by April 30 to be considered by the Nominating Committee at the Annual Meeting.

About the Nominee:

Name:

Company/University:

Address:

City:

State:

Zip / Postal Code:

Country:

Phone:

Fax:

Email:

Nominee's SEM Service Contributions:

1.

2.

3.

4.

5.

6.

7.

Service contributions the nominee has made to other organizations:

1.

2.

3.

About the Nominator:

Name:

Company/University:

Address:

City:

State:

Zip / Postal Code:

Country:

Phone:

Fax:

Email: