DSPNET Office Nomination Form

International Fraternity of Delta Sigma Pi

OFFICIAL NOMINATION FORM
FOR NOMINATIONS AND CONSIDERATION FOR APPOINTMENTS

(This electronic submission mirrors the form found in Policy
and Procedures Section N, Policy 3. A signature affirming the Code of Conduct is
required and may be electronically submitted via this form.)

This electronic form may be used by those nominating or volunteering themselves.
If you are submitting on behalf of someone else, please download the form and submit as instructed.
You may select only one Elective Position and/or one or more Appointed Positions.

*required field
Elective Positions:
Grand President	Provincial Vice President
Vice President-Finance	[ check one ]
Vice President-Organizational Development	North Central Northeastern
Regional Vice President:	South Central Southern
(Name of Region)	Western

NOTE: Candidates for elective office are encouraged to nominate themselves. All nominees for elective office must have been a member of Delta Sigma Pi for at least three years and an alumni member at the time of their election (See Bylaws Article IV, Section 4).

Appointed Positions: Check whether recommending or volunteering for national , provincial , or either level.
District Director (Appointed by Regional Vice President)	Chapter Advisor (must be on faculty & elected by collegiate chapter)

Committees:
Alumni Development Committee	Organizational Development Committee
Community Service Committee	Professional Development Committee
Finance Committee	Provincial Discipline Committee
Nominations Committee	Other (please name)

* Name of Nominee: / Volunteer		* Chapter/Initiation #:
* Home Address:		Date of Initiation:
		Daytime Phone #:
		Evening Phone #:
Name of Employer: or Business		Fax #:
Job Title:		* Email Address:
Work Address:		Date of Graduation:
		College/University:

Collegiate Chapter Offices or Responsibilities Held:

Brief description of employment responsibilities:

Alumni Chapter Affiliation? Yes No

(Name of Primary Alumni Chapter)

Alumni Chapter Offices or Responsibilities Held (include dates):

National Activities or Responsibilities Held (include dates):

*Statement of Platform:
Outline your goals for the Fraternity in the position being sought. This statement
cannot exceed 200 words. This statement will be published as submitted up to 200
words (see #6 below). Note: This form does not spell check, nor does it do word count.

All information requested on this form must be supplied if the recommendation or nomination is to be considered. If any item is non-applicable, please write in N/A.

All nominees must agree to abide by and support all Fraternity Bylaws, Ritual and policies (refer to "Leadership Code of Conduct" Policy CC.) and indicate so by signing or acknowledging the certification statement provided below. No candidate will be placed in nomination until an actual signature or acknowledgement affirming the Leadership Code of Conduct is obtained indicating this certification (see Policy N.1.A.). Incumbent officers seeking re-election must submit a new signed Leadership Code of Conduct affirmation.

By submitting this electronic form, it will be forwarded to the Executive Director at the Central Office and the Nominations Chair.

Nominations for the national elections held at Congress received at the Central Office by March 15 will be posted on www.dspnet.org for consideration prior to Congress. After March 15, any further nominations for election at Congress (This form can still be used online after March 15 but a formal "verbal nomination" must also be made from the floor at GCC.) must be made from the floor during a business session.

Nominations to fill PVP or RVP vacancies are due to the Central Office within the timeframe stated in the call for nominations.

Note that candidates for elective office are asked to submit a Statement of Platform and/or comments. This statement is not to exceed 200 words by actual word count. The statements are published and/or distributed for review by voters. Only the first 200 words, by actual count, of any statement will be published. If a platform statement is not received at the Central Office by March 15, it will not be published and "none submitted" will be noted on the nomination report. Once a statement is published on the web, it cannot be altered by the nominee; the Fraternity retains the right to make corrections as needed.

The city of residence, state and an email address for all nominees will be posted on www.dspnet.org. No other contact information will be published related to election purposes.

CANDIDATE AFFIRMATION OF RESIDENCY AND LEADERSHIP CODE OF CONDUCT

I am aware of the responsibilities of this position; am willing to devote the necessary time, effort and travel; and agree to serve if elected. I hereby certify that I have read and understand the regional and provincial boundaries of the region and/or province that I am seeking office to represent, and I confirm that I reside within the boundaries of said entity, and that should I move my residency beyond the boundaries of said entity prior to election for same, I will withdraw my candidacy. Should I be elected and subsequently, during my term of office, move my residency beyond the boundaries of said entity, I will resign my position. I further certify that I have read and fully understand the Fraternity's Leadership Code of Conduct and, if elected, will fully comply with the policy. I further understand that failure to adhere to this policy could result in disciplinary action up to, and including, expulsion in accordance with the Individual Discipline Policy.


Digital Signature of Nominee		Date:

Name of Nominee	Chapter & Number	Email Address and Phone

Once completed, click submit and the form will be sent to the Executive Director at the Central Office and the Nominations Committee Chair.

If you have questions about the nominations process, please contact the Central Office
or a member of the Nominations Committee.

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International Fraternity of Delta Sigma Pi

OFFICIAL NOMINATION FORM FOR NOMINATIONS AND CONSIDERATION FOR APPOINTMENTS

OFFICIAL NOMINATION FORM
FOR NOMINATIONS AND CONSIDERATION FOR APPOINTMENTS