FERMILAB USERS EXECUTIVE COMMITTEE
NOMINATION FORM
The undersigned members of the Fermilab Users Organization nominate
________________________________ ________________________________
Name Institution
for membership on the Users Executive Committee. He/She has indicated a willingness to serve as indicated by signature. This form should be received at the Fermilab Users Office, MS 103, Batavia, Illinois 60510, no later than noon on Tuesday, June 8, 2004.
SIGNATURE OF MEMBER PRINTED NAME
1. ___________________________________ ___________________________________
2. ___________________________________ ___________________________________
3. ___________________________________ ___________________________________
4. ___________________________________ ___________________________________
5. ___________________________________ ___________________________________
6. ___________________________________ ___________________________________
7. ___________________________________ ___________________________________
8. ___________________________________ ___________________________________
9. ___________________________________ ___________________________________
10. ___________________________________ ___________________________________
11. ___________________________________ ___________________________________
12. ___________________________________ ___________________________________
Signature of Nominee _________________________________________