New & Current Board Member Information Form

Superintendents and/or superintendent secretaries, please provide your current board member information, along with the offices held, as of the November 2011 elections. On the bottom of the form we also ask that you also list board members who did not run, were not re-elected or were term-limited at the time of the election. 

Contact Information

* Required

District *
Contact person *	Title *
Email *	Phone *

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Your District Board Member Information

Please list information of all members of the board as of November 1, 2011 election:

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

(Do not use dashes, slashes or spaces)

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

Salutation Ms. Mrs. Mr. Dr.	Title Veteran Board Member Newly Elected Appointed Legislative Network Liaison
First Name	Last Name
Email	School Board Office Held President Vice President Secretary Treasurer
Date Elected or Appointed to Board	Date Term Ends
Preferred Mailing Address (include business name if applicable) Home School Business	Address
City	Zip
Preferred Phone Home Work Cell	Phone Number (Do not use dashes, slashes or spaces)

Please list the names of the board members who either DID NOT RUN, were NOT RE-ELECTED or were TERM-LIMITED on November 1, 2011.