Commonwealth
Applications
Gubernatorial Appointments
Nomination for Gubernatorial Appointment
Nominator Profile
Title
First Name
Middle Initial
Last Name
Email
Nominator Organization
Are you submitting this nomination on behalf of an organization?
Yes
No
If yes, Nominating Organization:
If yes, describe your position in the organization:
Nominee Position
Nomination For
Secretariats
Public Entities
Position
Describe the experience, interests and other background information about this nominee that would qualify this person to serve on the Board
(2,000 characters max).
Nominee Profile
First Name
Middle Initial
Last Name
Address
City
State
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Zip Code
Home Phone
Mobile Phone
Work Phone
Fax Number
Email
Nominee Employment
Upload Resume in either Microsoft Word or Adobe Acrobat PDF format
(Maximum file size accepted - 10MB (10,240 KB))
Employer Name
Job Title
Employer Address
Employer City
Employer State
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Employer Zip Code
Optional
Nominee Gender
Male
Female
Date of Birth
Country Of Birth
Ethnicity
Select Ethnicity
*undisclosed
Arab/Middle Eastern
Asian/Pacific Islander
Black/African American
Indian
Latino/Hispanic
Native American
Other
White/Caucasian
Education
Please review your information thoroughly before clicking submit.
Back to Top