Nominations 2021 Nominations 2021 Check all that apply* MCCC At-Large Director MTA Annual Meeting Delegate NEA Representative Assembly Delegate Name* First Last Please use your full first name as it would appear in our database. For example, Patricia or Patrick, not Pat.Ballot Name:*Name as you would like it to appear on the MCCC ballot. For example, PATRICIA SMITH-JONES above might be Pat Jones here. Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*College*Select a CollegeBerkshireBristolBunker HillCape CodGreenfieldHolyokeMass BayMassasoitMiddlesexMount WachusettNorth ShoreNorthern EssexQuinsigamondRoxburySpringfield TechnicalSelect a CollegeWork PhonePrimary MCCC Membership:*Full TimeDCEPart Time DaySex:*FemaleMaleEthnicity: American Indian/Alaska Native Asian Black Hispanic Native Hawaiian/Pacific Islander Unknown White (not Hispanic origin) Other Racial or Ethnic Minority Email address:* Enter Email Confirm Email Note: All communication with candidates is by email. 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. A personal email address is greatly preferred and usually more reliable in our large email mailings.MCCC At-Large Director At-large Director nomination requires signatures of at least 10 MCCC Members. AT LARGE PART-TIME DIRECTOR NOMINATION SIGNATURE FORM Signature Forms can also be downloaded at https://mccc-union.org/nominations/* I understand I have to submit signature forms MCCC At-large Part-time Adjunct Director CandidateAt Large Director (Two to be elected)At-large Director nomination requires signatures of at least 10 MCCC Members. MTA CandidatesThis section is for MTA Candidates MTA Annual Meeting Delegate (Springfield: Friday April 30 and Saturday May 1, 2021) ALSO, please check if First Time MTA Delegate I wish to be on the ballot as a candidate for MCCC Delegate to the MTA Annual Meeting of Delegates in Springfield. I understand that this commitment normally requires attendance on Friday and Saturday. There is a $25 per day stipend mailed to delegates after the meeting.Email Use by Candidates - Opt Out:YESNODo you want to "opt out" of the use of your email by candidates for MTA office? 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 delegate's mailing address, but not with the delegates' email address."NEA CandidatesThis section is for NEA Candidates NEA Representative Assembly Delegate (Denver: July 2 - July 6, 2021) ALSO, please check if First Time NEA Delegate I wish to be on the ballot as a candidate for MCCC Delegate to the NEA Annual Meeting of Delegates.Badge Name: First Last "Enter Badge Name as the delegate prefers to have printed on the badge at the NEA meeting. Be sure to include the Last Name. Limit to 30 characters if possible."Personal Email: Enter Email Confirm Email "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:YESNO "Check this box to limit the use of delegate’s personal email address for Association business only." Green Participant:YESNO "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:Select oneTeacherLibrarian, Councelor, NurseOtherIf "Other" please specify:Cell PhoneOPTIONAL NEA INFORMATION "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." OPTIONAL NEA CANDIDATE STATEMENTNEA Candidate statements are provided with the election ballots. 50 word limit - Will be formatted as one paragraph. Words above 50 will be deleted.