Advisory Council Nomination Form

The NSVRC staff is guided and assisted by a diverse and distinguished national Advisory Council committed to ending sexual violence. Council members serve a three-year term 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 yourself or someone else (with their permission) for the NSVRC Advisory Council please complete the information requested in the following form. Nominations are reviewed annually.

Nominee's Info
Enter the following information about the person you'd like to nominate for the NSVRC Advisory Council
Describe experience in sexual violence prevention and other relevant areas:
Describe experience in collaboration, board work, team work, and/or consultation:
Describe expertise in working with people of different social, ethnic and gender backgrounds or any experience that reflects a commitment to cultural competency, diversity, and anti-oppression work:
List any noteworthy contributions to the anti-sexual violence movement (practice, research, policy, public health, technical assistance, training, media, advocacy, etc.):
List three qualities/expertise that would enhance the activities of the NSVRC:
List three references with email, phone number and affiliation:
Nominator Information
*If this is a nomination, we ask that you obtain permission from the nominee before submitting. Please include your name and contact information if you are making a nomination.
By submitting this form, you accept the Mollom privacy policy.