HNBA Executive/Judicial Endorsements Nomination Form

Name:*
Address:*
E-mail 1:*
E-mail 2:*
Work Telephone:*
Cell Number:*
Are you a U.S. Citizen?*
State whether you are a member of the HNBA:*

SOCIAL MEDIA

Please provide links to your social media pages.

Facebook:
Twitter:
Instagram:
LinkedIn:

FOR JUDICIAL CANDIDATES

Are you applying for a specific judicial vacancy?*
If so, which one?

FOR EXECUTIVE ENDORSEMENT CANDIDATES

List your top three preferred agencies, offices and positions:*

SELF-CERTIFY

Have you ever used illegal substances?*
Have you ever been convicted of a misdemeanor or a felony?*
Have you ever violated any federal tax, employment, criminal, or other laws?*
If you answered YES to any of the above, please explain in detail.

UPLOAD DOCUMENTS

CV:*
Judicial Endorsement Questionnaire OR Executive Appointment Certification Form:*
Letters of Support (not required):