CANNP Nominations Form

Office Nominated for (check one) *
Nominee Name *
Nominee Name
Home Address *
Home Address
Home Phone *
Home Phone
Work Address
Work Address
CANNP Committee Membership
I am interested in serving on the following committee:
I would be interested in serving as Co-chairperson for the committee below:

Form will be submitted to Felicia Soza at greyhaven1@aol.com

Please have Nominee feel out Nominee Information Form located online or paper form.  Form can be found on Resources page.