FCS 747 11-2016
AEHC District Director Consent of Nominee Form
In odd-numbered years, return this form to Melody Curtis at the state district office, 2301 South University Ave., Little Rock, AR 72204 by May 15.
I,
am willing to have my name placed in nomination for the office of
for a two-year term and certify that I have studied the qualifications and responsibilities of this office as outlined in the Bylaws and Standing Rules.
Address
City	State	AR	Zip Code
County	Phone
Email Address
Date	Nominee Signature
Recommendation
The above nominee is recommended for the office of
and is a qualified member of the	County Extension Homemakers Council.
Date	CEA-FCS Signature
Date	County Council President or Appropriate Officer Signature
If the CEA-FCS position is vacant, the recommendation may be made by the CEA-Staff Chair.
The University of Arkansas System Division of Agriculture offers all its Extension and Research programs to all eligible persons regardless of race, color, sex, gender identity, sexual orientation, national origin, religion, age, disability, marital or veteran status, genetic information, or any other legally protected status, and is an Affirmative Action/Equal Opportunity Employer.