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MPA Advisory Board Nomination Form

Nominations to serve on the Middle Peninsula Advisory Board are accepted on a rolling basis. Nominees must represent the private-sector (business or non-profit). Nominees must reside in, or their business must be located in, counties in the Middle Peninsula (Essex, Gloucester, King & Queen, King William, Mathews and Middlesex).

The mission of the Middle Peninsula Alliance is to promote the assets of Virginia’s Middle Peninsula by connecting people, ideas and resources to develop new opportunities and visibility for the region.

Date of Nomination *

Nominator First Name *

Nominator Last Name *

Nominator Phone *

Nominator Email *

Nominee First Name *

Nominee Last Name *

Nominee's Employer/Company (if applicable) *

Nominee's Title/Position *

Nominee's Phone *

Nominee's Email *

Locality Represented by Nominee *

In your own words, please describe why this nominee is an exceptional candidate for the Advisory Board of the Middle Peninsula Alliance (5000 character limit). Please consider the nominee's business experience, civic involvement, creativity, and vision for the future. *