Finance Chair Senior Vice Chair Safe Sport Chair

2016 BOARD OF DIRECTORS NOMINATION FORM

Deadline April 1, 2016 Board of Directors

POSITION: Please check one. Nominees may check only one box.

□ General Chair □Administrative Vice Chair □Secretary □Delegate at Large

□Finance Chair □Senior Vice Chair □ Safe Sport Chair

□Nominating Committee Member

Nominee’s Full Name: ______

Address: ______City: ______State:______

Telephone: (#1) ______(#2) ______(fax) ______

E-mail: ______

Consent by Nominee: I, (please print name) ______, hereby consent to allow my

name to stand for nomination to the Midwestern Swimming Board of Directors.

______SIGNATURE OF NOMINEE

Please Complete the Following Section If You Are Nominating Someone For The Board

Nominated by: ______

Address: ______City: ______State: ______

Telephone: (#1) ______(#2) ______(fax) ______

E-mail: ______

______SIGNATURE OF NOMINATOR

Please Return Form To: Nominating Committee,c/o Carol Olson, 16016 South 63rd Street, Papillion, NE 68133 OR emailall the information contained on this form to any member of the Nominating Committee:

Anne Cvrk - ; Anya Lindholm ; Carol Olson - ;Analisa Peterson - ; Brian Schaenzer –

FROM THE MIDWESTERN SWIMMING, INC RED BOOK: PUBLICATION OF NOMINATIONS - Nominations by the Nominating Committeeshall be published by distributing a slate of candidates together with the positions for which they have been nominated to each member of theHouse of Delegates and to each Group Member not less than twenty (20) calendar days prior to the election. This notice may be combined withthe notice of the meeting pursuant to Section 4.15.1 where convenient. See Section 16.1.5 for the methods which may be used for thedistribution.The Nominating Committee will publish the slate of candidates no later than April 8, 2016.

To appear on this slate, nominations must be received by the nominating committee no later than
April 1, 2016.AND: ADDITIONAL NOMINATIONS may be made from the floor of the House of Delegates by any member of theHouse of Delegates eligible to vote. Please contact a Nominating Committee member for additional information.