Advisory Council Nomination Form

The staff of the NSVRC is guided and assisted by a diverse and distinguished National Council committed to ending sexual violence. Council members serve three-year terms during which time they participate in quarterly conference calls, annual meetings, committee work, and provide consultation on a variety of topics as needed. To nominate someone for the NSVRC Advisory Council please complete the information requested in the following form. Nominations are reviewed periodically. *If this is a nomination, we ask that you obtain permission from the nominee.

Nominee's Info

Enter the following information about the person you'd like to nominate for the NSVRC Advisory Council

Name *

Address *

Phone (work)

Phone (home)

Fax

Email

Title

Organization

Areas of expertise

Anti-sexual violence work experience

Describe experience in anti-sexual violence work and/or any other relevant experience.

Collaboration experience

Describe experience in board work, team work, negotiation and hands-on collaboration

Diversity experience

Describe expertise in working with people of different social, ethnic and gender backgrounds or any other experience or work that would reflect a commitment to cultural competency

Anti-sexual violence movement contributions

List any noteworthy contributions to the anti-sexual violence movement

Qualities/Expertise

List three qualities/expertise that would indicate an essential match to enhance the activities of the NSVRC.

Qualities/Expertise

References

List three references with address, phone number and affiliation.

Reference

Nominator Information

Name and contact information of person making the nomination

Name

Address

Phone (work)

Phone (home)

Fax

Email

Title

Organization

Additional Comments

By submitting this form, you accept the Mollom privacy policy.

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Advisory Council Nomination Form

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