Nomination Form – 2nd Popular Palestinian Conference

NOMINATION FORM

for Election of National Facilitators on Coordinating Committee

Please submit to the USPCN registration table or online using the form below, or emailing your completed downloaded form to generalassembly@palestineconference.org no later than midnight on Saturday October 30^th.

*(denotes required field)

Name: *

E-Mail Address: *

City *

Phone Number *

Registration Number

In 150 words, please describe yourself and your interest in being a USPCN Coordinating Committee member:

Describe your experience with the USPCN:

Please list some of your ideas for building USPCN:

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