BBWG Nomination Form

Name of Nominee *

First

Last

Your Name - Nominator (if different than above)

First

Last

Contact Email *

Nominee's Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Beacon Baddeck Working Group (BBWG) Expertise: *

Explain your Expertise selection(s) *

Describe your experience in this area and how you could benefit the BBWG due to your experience.

BBWG Connections: *

Explain your Connections selection(s)

Describe your experience in this area and how you could benefit the BBWG due to your experience.

BBWG Demographics *

Why are you interested in being part of BBWG? *

What does being a resident of Baddeck or area mean to you? *

How are you willing to commit time and energy towards this plan? *