CPPC

Contact CPPC button white


 

Google logo with words


 weather button with words

 

Google Maps button white

 

USPS Button white

 

CPPC Board Nominee Application

         CPPC Board Nominee Application


Name: __________________________________________________________________

Company: ______________________________________________________________

Phone: _________________________________________________________________

Email: _________________________________________________________________

Number of years as a CPPC Member: _______________________________________

Last CPPC event you attended: _____________________________________________

What you believe you can bring to the CPPC Board: _________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________
 

(attach additional page if more space needed or downloadable form found on web site under CPPC 2022 Workshop event files)

Are you aware of any Conflicts of Interest that would prevent you from serving on the CPPC Board?

                                                                                 No_________________________________________________

                                                                                                                        (signature required)

Have you read, understand and willing to sign the Code of Ethics Document required to be signed by a CPPC Board member each calendar year?                                               
                                                                                Yes_________________________________________________

                                                                                                                        (signature required)

Have you read and understand the CPPC By Laws and Policies pertaining to being a member of the CPPC Board?

                                                                                Yes_________________________________________________

                                                                                                                        (signature required)

 Do you understand, acknowledge and are willing to commit to the time needed to be a member of the CPPC Board?   

                                                                                 Yes ________________________________________________

                                                                                                                        (signature required)

 

Signature:______________________________________            Date:_____________________________________

Printable document, select this link:   Nominee Application