Massachusetts Community College Council

Write-In Candidate Form - 2017 - Thursday, March 30, 2017 - 8:21 pm



This is a follow-up to the voting ballot. It applies to Write-In nominations.

If a person's name is written-in on the ballot, that person is NOT an official nominee unless that person fills out the information below. If this form is not received by Friday March 31, 2017, that person cannot be elected.

A write-in candidate must file this form by
Friday, March 31, 2017, 4 p.m.
Nomination materials that arrive late will not be accepted.

Most fields below are REQUIRED. These are indicated with Underlining.

This form is to be used for write-in nominations for delegate to the
MTA Delegate Assembly and NEA Representative Assembly.


This section is for all Candidates

Name
 
FULL First Name (*)   Last Name

(*) Please use your full first name as it would appear in our database. For example, Patricia or Patrick, not Pat.


Home Address

Address 1

Address 2

   
City State Zip
Home or Cell Tel #

- -         Home       Cell


College

Work Tel #

- - x


Primary MCCC Membership:      

Sex:   

Ethnicity:

American Indian/Alaska Native
Asian
Black
Hispanic
Native Hawaiian/Pacific Islander
Unknown
White (not Hispanic origin)
Other Racial or Ethnic Minority

 


Email address: *
* Personal email addresses are preferred for MCCC business.

Verify email address by retyping here: Emailverify

Note: If the Email address is not filled in correctly we cannot email a copy of your electronic submission back to you. No other copy will be returned to you.

All communication with candidates is by email.


This section is for MTA Delegate Candidates

I am not interested in being an MTA Delegate.
(if you are interested, select the "Candidate for MTA Annual Meeting Delegate" button below).

I wish to be a write-in candidate for MCCC Delegate to the MTA Annual Meeting of Delegates in Boston. I understand that this form is not a vote; to be a write-in candidate
(1) your name must be written-in on at least one ballot and
(2) this form filled out and submitted by the deadline.
I understand these two requirements to be elected as a MTA delegate.

I understand that this commitment normally requires attendance on Friday and Saturday.

There is a $50 per day stipend paid to delegates.


Email Use by Candidates - Opt Out:   YES    NO  

Do you want to "opt out" of the use of your email by candidates. Here is the MTA statement..

One of the vital responsibilities of delegates to the MTA Annual Meeting is the election of candidates for MTA office. In order for candidates to communicate with delegates concerning their candidacy, MTA provides candidate with delegate contact information. Candidates are instructed that the information is provided for use in connection with the election only and may not be used in any purpose after the election. MTA will honor the request of any delegates who do not wish to be contacted by email, in which case candidates will be provided with the delegates mailing address, but not with the delegates email address.


HOTEL
Delegates living more than 25 miles from Boston qualify for an MCCC-paid shared, double-occupancy hotel room at the conference hotel. After elections electees are given a chance to indicate a preferred roommate.
I would NOT NEED a hotel room.
I might NEED a hotel room.

 

This section is for NEA Delegate Candidates

I am not interested in being an NEA Delegate.
(if you are interested, select the "Candidate for NEA Representative Assembly Delegate" button below).

I wish to be a write-in candidate for MCCC Delegate to the NEA Representative Assembly in Boston. I understand that this form is not a vote; to be a write-in candidate
(1) your name must be written-in on at least one ballot and
(2) this form filled out and submitted by the deadline.
I understand these two requirements to be elected as a NEA delegate.

I understand that this commitment normally requires at least four days of attendance, and one day in early June.

Please check here (and above) if First Time NEA Delegate

Candidates for NEA/RA MUST submit additional information required by the NEA. See below.

REQUIRED NEA INFORMATION
Italicized quotations are from the NEA instructions for their form.

Badge Name:
"Enter Badge Name as the delegate prefers to have printed on the badge. Be sure to include the Last Name. Limit to 30 characters if possible."

Personal Email:
Verify email address by retyping here: Email Verify
"To improve delivery and availability of meeting resources for all delegates, NEA requires that each delegate and successor delegate include a personal email address so that the Association may provide secure access to online meeting resources. Delegates who do not have a personal email address may indicate N/A."

Email Restrict:      YES        NO
"Check this box to limit the use of delegate’s personal email address for Association business only."
Green Participant:    YES        NO
"In continuing efforts toward good stewardship of Association resources at the Annual Meeting, NEA promotes the GreenDelegate Initiative. Participating delegates who wish to “go green” will have the option of using online delegate resources in place of traditional print materials. To participate in this special initiative, check the “Green Participant” box and be sure to provide a Personal Email address."

Position Code: (Teacher includes Professor, etc.)
If "Other" please specify:


OPTIONAL NEA INFORMATION
Cell Phone:
"We collect the Cell Phone to aid in contacting delegates at the RA for various reason; emergencies, lost wallet, driver’s license, etc., or relaying information regarding family members."

After submitting this form, you should receive (1) a report on your browser window and (2) an automatic email reply. This confirms that an email with your nomination was sent to the MCCC office, which keeps track of nominations.

If you do not receive an email confirmation shortly after submission please contact the office. You may not be registered in that case. Contact Office.


Deadline for Completed Applications to be RECEIVED :
Friday, March 31, 2017, 4 p.m.


Notice: To minimize any chance of a lost nomination, a copy of this electronic document is emailed to the