Election Nomination Form Nominations due August 16, 2024. Election Nomination Form - 2024 Nominee Name:* First Last Email* Cell Phone*Job Title* Company*Candidates must be employed by an AAA active member organization. Nominee Region*Region I (CT, MA, ME, NH, NJ, NY, RI & VT)Region II (AL, DE, DC, FL, GA, MD, MS, NC, PA, SC, VA, WV)Region III (IL, IN, KY, MI, OH, TN WI)Region IV (AR, IA, KS, LA, MN, MO, OK, ND, NE, SD, TX)Region V (AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, WY)Position(s) You Are Interested in Running For?* President-Elect Treasurer Secretary Region 1 Director Region 2 Director Region 3 Director Region 4 Director Region 5 Director Nominee HOME Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Candidate Statement (No more than 250 words):*Areas of responsibility within your organization (administrative, operational, billing, etc.):*About Your Ambulance ServiceNumber of Ground Ambulances* Number of Employees* Does the ownership or board of your organization commit to your travel and full participation for your term?* Yes No Past involvement with AAA (Committees, etc.):*Current or past EMS certifications (EMT, Paramedic, etc.) and year certified:*Years in the ambulance industry:* Brief history of career in EMS:*What would you identify as the top three issues in emergency medical services?*What do you believe are the three priorities for the AAA?**High Resolution* Headshot Photo*Please upload a recent headshot photo for inclusion on the candidate page.Accepted file types: jpg, gif, png, eps, Max. file size: 1 MB.EmailThis field is for validation purposes and should be left unchanged.