2 AEB Egg Nomination Form

NOMINATION FORM
AMERICAN EGG BOARD — 20XX-20XX TERM
AREA XX
Nomination for Member and Alternate: List first and second choice for member and alternate.
Four separate names must be listed for the nomination schedule to be accepted.

Member A
1st choice

2nd choice

__________________________
Name

Alternate A
1st choice __________________________
Name

__________________________
Daytime Phone

__________________________
Daytime Phone

__________________________
City & State

__________________________
City & State

__________________________
Name

2nd choice __________________________
Name

__________________________
Daytime Phone

__________________________
Daytime Phone

__________________________
City & State

__________________________
City & State

Member B
1st choice

2nd choice

__________________________
Name

Alternate B
1st choice __________________________
Name

__________________________
Daytime Phone

__________________________
Daytime Phone

__________________________
City & State

__________________________
City & State

__________________________
Name

2nd choice __________________________
Name

__________________________
Daytime Phone

__________________________
Daytime Phone

__________________________
City & State

__________________________
City & State

Caucus Leader for next year (20XX): ________________________________
_______________________________
(Name)

2-AEB (Rev. 04/17)

(Organization)

See reverse for burden/non-discrimination

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