PIR Board of Directors Nomination Form

"*" indicates required fields

I would like to*

Myself

A third party. I have only the nominee’s name and e-mail address

A third party. I have all the information on the nominee

Nominator's details

Nominator Name*

Prefix First Last

Nominator's Email*

I have notified the nominee and have their consent for this nomination.*

Yes

No

If yes, the confirmation e-mail of this nomination will also be sent to the candidate. If No, an e-mail will be sent from the Nominating Committee to the candidate notifying them of their nomination and requesting confirmation of their willingness to be considered.

Nominee's details

Candidate Name*

Prefix First Last

Candidate's Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Biographical information highlighting relevant experience, expertise*

Upload File

Drop files here or

Accepted file types: pdf, txt, doc, docx, odt, rtf, html, Max. file size: 10 MB.

References (2-3)*

Statement of interest and qualifications*

As manager of one of the world’s largest top-level domains, PIR is engaged in a highly competitive industry. Please list any potential conflicts of interest you suspect the nominee may have*