Trustee Nominating Form

Town of Hennessey Board of Trustees Nominating Form

Dear Candidate:

Please complete the following information to assist our Town Board in appointing an unexpired board term.  This is a fillable PDF, which you need to print out and either fax or return as a PDF by emailing to the Town Clerk.  Thank You.

Name *

First

Last

Home Address *

Present Employer *

Dates of Employment *

Title or Position *

Work Address *

Home Phone *

work Number *

Cell Phone *

Fax Number

Email *

Are you a registered voter? *

if yes, for how long/where? *

Why would you like to serve on the Hennessey Board of Trustees? *

Are you willing to file for candidacy if the position is put up for election? *

• Yes
• No

Current or past memberships in clubs, civic organizations or associations:

Current or past positions held on Committee or Boards including organization name, title, description of duties and dates held:

Experience and familiarity with board responsibilities: *

Are you willing to attend an 8 hour class within 6 months of appointment? *

• Yes
• No

Please supply any other information that you believe should be considered in evaluating your application to be a Town Board of Trustees:

Submit

123 S Main, Hennessey, OK 73742
(405) 853-2416
Fax 405-853-2494