Declaration of Candidacy
for
OEA Delegate
Member ID#
(found on your OEA Membership Card,
NEA Today or Ohio Schools label)
___ ___ ___ ___ ___ ___ ___
________________________________________
Date of Application
I, ______________________________________________________________, request that my name be entered
onto the ballot to elect delegates to the 2021–2022 OEA Representative Assembly.
If I am elected as a delegate, I promise to attend all sessions. Additionally, I shall share information gained with
other CEA members. In the event I am unable to serve as a delegate, I will immediately notify the CEA President in
order that an alternate may attend.
(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
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.
Declaration of Candidacy for OEA Delegate
(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 OEA DELEGATE
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
