(ISC)²Phoenix Chapter Board Candidacy Form

(ISC)² Phoenix Chapter seeks a strong diverse board reflecting our membership and our identity. To nominate a candidate to serve on the board, or to serve yourself, please complete and submit this form prior to the deadline for nominations. Thank you.

Candidate Info

Candidate Name:(*)

Please enter the candidate name.

Candidate (ISC)2 Member # :(*)

Please enter the candidate (ISC)2 Member #.

Candidate Personal Address: Do not use business address or P.O. box address.(*)

Please enter the candidate address.

Candidate City:(*)

Please enter the candidate city.

Candidate State:(*)

Please enter the candidate state.

Candidate Zip:(*)

Please enter the candidate zip.

Candidate Phone:(*)

Please enter the candidate phone number. nnn-nnn-nnnnn

Candidate Email:(*)

Please enter the candidate email address.

Is the candidate able and willing to sign a CERTIFICATE OF DISCLOSURE as required by the State of Arizona elected?(*)

Yes

No

Please select this.

Please, include a Brief Biography to be used on the ballot, the (ISC)2 Phoenix Chapter website and in other promotional sites/materials. Recommended length is 250 words or less.(*)

Invalid Input. Please only use letters, special characters, and numbers.

Photograph (8MB max)(*)

Please upload your photo.

Which position(s) is the candidate willing to serve or nominate this candidate?(*)

Vice President (1 year Term)^^^
^^^Vice President: This person shall be elected each year during annual elections. The person elected as Vice President shall serve for a one-year term, after which time he or she will become the President. The Vice President must have served 6 months as a Board member within the last two years prior to taking office.

VP External Relations (2 year Term)

VP of Programs (2 year Term)

VP Communications (2 year Term)

VP of Educational Programs (2 year Term)

VP of Membership (2 year Term)

Secretary (2 year Term)

Treasurer (2 year Term)

Director-at-Large (2 year Term)

Please select this.

Why are you excited about serving the Chapter as a member of the board? Or why are you excited about nominating this candidate to serve?(*)

Please complete this field.

Is the candidate currently serving as board member or officer of an organization? If yes, provide the name of the organization, the role and term of service (i.e. When does the term of office expire).(*)

Please mention if the candidate is currently serving another organization.

What qualities and experiences will the candidate bring to the board?(*)

Please complete this field.

Interview Scheduling

Nominating interviews will be held in the evening between 7:00pm and 9:00 pm.

What is the best phone number to reach you to schedule a phone interview?(*)

Please provide the number for the phone interview.

Preferred Interview Date 1:

Please select the contact time.

Preferred Interview Date 2:

Please select the contact time.

Nominator

Are you self nominating?(*)

Invalid Input

Nominating Name:(*)

Please enter the nomination name.

Nominating Phone:(*)

Please enter the nomination phone number.

Nominating Email:(*)

Please enter the nomination email address.

Nominating (ISC)2 Member # :(*)

Please enter the nomination (ISC)2 Member #.

How do you know the candidate?(*)

Please mention how do you know the candidate.

Thank you for participating in the (ISC)² Phoenix Chapter.