Please enable JavaScript in your browser to complete this form.Name of Nominee *FirstLastContact Information for NomineeEmail, Phone NumberMember Status of NomineeThe nominee has been a member in good standing of LVJS for at least one of the last five yearsCheckboxesYesNoDon't KnowConsent of Nominee Has nominee consented to be nominated and serve if electedCheckboxesYesNoDon't knowName of Person Making Nominatiom *FirstLastDeadline for Submission: October 15, 2021Date / TimeDateTimeMessageSubmit