Fillable Printable 2012 Letter of Intent Form

2012 Letter of Intent Form

2012-2013 Council of Regents Election

Letter of Intent

Regent Area:

Candidate Name:

Title:

Organization:

Business Address:

Business Phone:

Email:

Fax:

By submitting my name to run in the 2012-2013 Council of Regents Election I accept that I will abide by

ACHE’s Bylaws, Code of Ethics, Regulations and other rules relating directly to the election process.

Signature: ____________________________________________________________________________

Date: ___________________________________________

Please return this Letter of Intent to elect[email protected] by August 31, 2012 or via certified letter

postmarked by August 31, 2012 to:

Jennifer L. Connelly

ACHE

1 N. Franklin St, Suite 1700

Chicago, IL 60606-3529