(ISC)2 Chapter Phoenix

(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 Name:(*)

Please enter the candidate name.

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.

Candidate Email:(*)

Please enter the candidate email address.

Candidate (ISC)2 Member # :(*)

Please enter the candidate (ISC)2 Member #.

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 #.

Interview Scheduling: Please provide a telephone number where you may be reached to schedule a phone interview with the Nominating Committee/Directors. Nominating interviews will be held in the evening between 7:00pm and 9:00 pm.(*)

Please provide the number for the phone interview.

Date:(*)

Please select the contact time.

Date:(*)

Please select the contact time.

1. How do you know the candidate?(*)

Please mention how do you know the candidate.

2. 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.

3. 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.

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

Please complete this field.

5. For which position are you willing to serve or nominate this candidate?(*)

Vice President (1 year Term)*

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.

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

YesNo Please select this.

7. 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.(*)

Please complete this field.

Photograph
Please include a high-resolution digital photograph. It will be used on the (ISC)2 Phoenix Chapter Elections information site..
Recommended Specification PPI: 72 Pixels Per Inch
File Types: JPEG, PNG or GIF
Size: The recommended image size is 150 pixels wide by 200 pixels high. However, any size image may be uploaded. Please note that the image will be scaled and not change the file size. This means that if 3 megabyte file taken from a digital camera is uploaded, the system will make this image appear smaller to the voter but it will still take as long to download as the full size image. Please note that large images may cause issues for voters with a slower internet connection.(*)

Please upload your photo.