MACA Board Nomination Form
Board Position to be nominated for:
Nominee's Supervisor's Name:
Nominee's Agency Address (Include State and Zip code)
Has the nominee ever been convicted of an animal law violation or felony of any sort?
Is the Nominee willing and able to commit to attending board meetings as necessary to conduct the Association’s business, and to attend MACA Training Venues?
# of years as a MACA Member:
Length of time the nominees has worked in an animal welfare position:
Supervisor's Agency Address :
Supervisor's Phone Number:
Supervisor's email address:
In the space below, please explain the nominee’s educational background, experience, qualifications and any other information stating why he or she would be a good candidate for an Executive Board position.