Officer Nomination Form Mosaic Officer ApplicationEmailFirst NameLast NameAre you a current Mosaic member? Yes NoWhich officer role are you applying for?- Select -Membership LiaisonTreasurerRecords SecretaryCommunications DirectorWellness RepresentativeAt-LargeWhy do you want to fill this position?What makes you a good candidate for this role?If elected, do you agree to sign a Data Usage Agreement? Yes NoDo you agree to uphold Mosaic's purpose? Yes NoSubmit Form