Declaration of Candidacy
for
CEA Ofce
Member ID#
(found on your OEA Membership Card,
NEA Today or Ohio Schools label)
___ ___ ___ ___ ___ ___ ___
________________________________________
Date of Application
I, ______________________________________________________________, declare my candidacy for the
position of ___________________________________________________________________________________
in the Columbus Education Association. I certify that I have been a member of the Columbus Education Association
for two years immediately preceding this election year and meet all other requirements for eligibility.
I further certify that I am willing to assume the responsibilities and obligations of the ofce, and that the term of ofce
for President and Vice President is for a two-year period and that the term of ofce for District Governor is for a
three-year period.
(Signature)
PLEASE PRINT CLEARLY:
NAME: ________________________________________________________
ADDRESS: _____________________________________________________
HOME PHONE: (____)_____________ CELL PHONE: (____)_____________
EMAIL ADDRESS: _______________________________________________
WORK LOCATION and POSITION: _______________________________________________________________
(As it is to be placed on the ballot; i.e., R. L. Smith or Bob Smith)
Street City ZIP
Declaration of Candidacy for CEA Ofce
(to be completed by CEA Elections Chairperson)
(Signature)
DATE RECEIVED:
__________________________________________________________________________
CEA ELECTIONS SECRETARY: _
______________________________________________________________
Race or Ethnic Minority:
(Check all that apply.)
American Indian/Alaska Native
Black
Hispanic
White (not Hispanic origin)
Asian
Native Hawaiian/Pacic Islander
Other Racial or Ethnic Minority
Please Specify:
___________
National Board Certied Teacher
Rev. 01/04/21 BH
DECLARATION OF CANDIDACY FOR CEA OFFICE
This form must be led with the Elections Secretary of the Columbus Education Association prior to 4:30 p.m. of
the deadline date of Friday, February 12, 2021, or bear a U.S. mail postmark no later than midnight of the dead-
line date. Forms should be sent electronically or mailed by U.S. mail service.
Return this form by U.S. Mail to:
Columbus Education Association
Attn: Elections Secretary
929 East Broad Street
Columbus, OH 43205
or
Return this form electronically to:
Attn: Elections Secretary
c/o crousem@ceaohio.org
