Please fill in ALL fields below. If you have any questions or problems contact Danny Sheckles at danny.sheckles@tnemsea.com.

DEADLINE TO BE SUBMITTED IS THE FIRST FRIDAY IN MAY!!
Name	*
Mailing Address
City
State
Zipcode
Email Address
Phone Number (Home)
Phone Number (Work)
Teaching Affiliation
Teaching Since
Board Member Position Region
Board Member Position At Large
Year Became TEMSEA Member
TEMSEA Member Number
Year Became TN I/C
TN I/C Number
Year Became TN EMT
TN EMT Number
Please briefly answer the following questions to introduce yourself to the nomination committee.
Why do you want to serve on the TEMSEA Board of Directors?
What skills or experience do you possess that would enhance the mission of TEMSEA?
Please list leadership positions you have held during your professional career you think will benefit TEMSEA?
Security Code	*