Application Form for MRCKC Vice-Chair Position The above MRCKC Executive Committee position is open for nomination. If you are interested in being a candidate for this position, please fill out the following form and return it to Nola Bienhoff. • via email: [email protected]; • U.S. mail: 600 Broadway St, Suite 200, Kansas City, MO 64105; • or fax: (816) 421-7758. Please also submit an updated resume with your nomination form. A nominating committee will review all nominations and will compile the final ballot. The vote will take place at an MRCKC Full Corps meeting. Name: ________________________________________________________________ Address:_______________________________________________________________ _____________________________________________________________________ Email: ________________________________________________________________ Phone #s: _____________________________________________________________ Occupation/Background: _____________________________________________________________________ Have you completed the MRCKC required trainings (Orientation, IS 22, IS 100, and IS 700)? Yes No If not, are you willing to complete the required trainings in the next three months? Yes No Please list the Emergency Preparedness Trainings you have completed: Please give reasons for seeking this position (i.e., what experience/skills you bring to the position, why you are interested in the position)