Lake Hennessy

Application for Nomination to the Napa Group Sierra Club Executive Committee

Send this completed form to Nancy Tamarisk at
<nancy@aya.yale.edu> or 11 Rockrose Ct, Napa 94558.

Please read the accompanying document for details of nomination procedures.
Fill in the information requested below in as much detail as you wish, and attach any other relevant information.

1.  Name:  

2.  Address:

3.  Telephone:

4.  Email:

5.  Sierra Club member id (8 digits): 

6.  What is your "day job"?

7.  Other relevant organizations in which you actively participate that may be taking positions on or have an interest in issues potentially under consideration by the Napa Sierra Club:


8.  Relevant experience, including as a Sierra Club volunteer:


9.  Why do you wish to be a member of the Executive Committee, and how do you think you can contribute?



10.  What are your areas of interest or concern related the Napa Group ExCom?



Applicant information shall be kept confidential and revealed only to Sierra Club officers with right and need to know.

We are not seeking information on your race, national origin, religious affiliation or lack of it, gender, age, sexual preferences, marital status or income.    However, political affliliation is relevant information.  Also, membership in organizations with environmental mission or close relationship to the Sierra Club's program (whether supporting or opposing) is also relevant.  Applicants shall disclose potential conflicts of interest.  Contact us for clarification if you wish.