U.S. Department of Transportation / Freight Transportation - National Freight Advisory Committee: Membership Nomination Form

National Freight Advisory Committee

Membership Nomination Form

Download the Microsoft Word Version [DOCX 18KB] to complete the form.

****Sample of the Microsoft Word Version****

Full Name
Title
Organization or Affiliation
Address
City		State	Zip
Telephone	( )		Email

Statement of Interest: Please describe why the nominee wants to serve on the NFAC and the unique perspectives and experiences the nominee brings to the NFAC (250 word limit).

Résumé: Please provide a résumé describing professional and academic expertise, experience, and knowledge, including any relevant experience serving on advisory committees, past and present (3 page limit).

Attachments:

An affirmative statement that the nominee is not a federally registered lobbyist, and that the nominee understands that if appointed, the nominee will not be allowed to continue to serve as a Committee member if the nominee becomes a federally registered lobbyist; and
Optional letters of support

SUBMIT NOMINATIONS:

All nominations should be emailed with the subject line 2013 NFAC Nomination to freight@dot.gov. Non-electronic submissions must follow the same format and contain the same information and be faxed to the attention of Shira Bergstein at (202) 366-0263 or mailed to:

Shira Bergstein
U.S. Department of Transportation
Office of the Secretary
Office of Policy
1200 New Jersey Avenue SE
Room W84-317
Washington, DC 20590

The Department is not responsible for any technical difficulties submitting a nomination form. Incomplete nominations will not be considered. All nomination materials must be received by midnight E.D.T. on March 21, 2013.

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