Delegate Candidate Information Form

All delegate candidates should fill out the following form.

Submissions are due April 2nd.

Please contact employeeforum@unc.edu if you have questions about this form.

Please complete one form per nominee.

Name*
First Last
Name as it should be listed on the ballot (includes full name and/or nickname)
Phone Number
Working Title
Department
Email
Campus Box Number
Years of University Service
Years of State Service
Supervisor's Name
First Last
Supervisor's Phone Number
Supervisor's Campus Box Number
Supervisor's Department
Supervisor Agree with Candidate's Service?
- Yes
- No
Chair or Department Head
Chair or Department Head Campus Box Number
Please submit 100 word biographical sketch (optional but suggested)
Other comments or questions?
Name
This field is for validation purposes and should be left unchanged.

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