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SECTION 1: Contact Information

Please complete this form to help us understand how you or someone you know might become more involved in VBSR.
  • If you are nominating someone for VBSR's Board of Directors, we will contact the nominee and ask them to complete a candidate profile.
  • If you are nominating yourself for VBSR's Board of Directors, please use this form instead.
  • More Information on VBSR's Board of Directors is available here.
  • More information on VBSR committees is available here.
Please be sure to click "Done" at the end of the survey. Thanks!

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* 1. Your Company/Organization

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* 2. Your first name

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* 3. Your last name

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* 4. Your email

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* 5. Your phone

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* 6. Candidate's First Name

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* 7. Candidate's Last Name

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* 8. Candidate's Company/Organization

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* 9. Candidate's Phone

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* 10. Candidate's Email

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