UTLA Elections – Declaration of Candidacy Form for Interim Valley East NEA Director

Declaration of Candidacy Forms

Declaration of Candidacy Form for Interim Valley East NEA Director

Deadline for receipt of this form is Friday, November 8, 2024, timestamped by 5:00 pm.

Name (required)

As you would like it to appear on ballot.

Affiliation
NEA

UTLA Area
Valley East

Employee ID Number (required)

Non-LAUSD Email (required)

Street Address (required)

City (required)

State (required)

Zip Code

Home Phone Number

Cell Phone Number (required)

School Phone Number

School/Site (required)

Permission is granted for UTLA to give contact information to members and media when requested
School SiteHome PhoneCell PhoneNon-LAUSD emailCheck those methods that are acceptable to give out.

Permission is given for the Elections Committee to verify my membership and to determine that I meet the requirements to be a candidate for the office for which I have declared
I agree

I declare the above assignment information true to the best of my knowledge. (required)
Checking this box represents your e-signature

I, __________, candidate for the office of NEA Valley East Director, do hereby declare that I will use the UTLA constituency chapter chair contact information for the sole purpose of contacting members to solicit their votes in connection with the election. I will only disclose this information to members who are participating in my campaign.

I will assure that anyone working to assist me in my campaign is aware that this information must only be used in connection with the election.

__________
Signature of Candidate

__________
Date Signed

This form goes to Princess Sykes of the UTLA Elections Committee, who can also be reached at psykes@utla.net or 3303 Wilshire Blvd., 10th floor, Los Angeles, CA 90010 or 1–213–368–6220.