Board of Directors - Candidate Submission Form
Region Represented

Affidavit of Candidacy

By submitting this electronic form, I am hereby submitting my name as a candidate for a seat on the Board of Directors of the Illinois Emergency Medical Technician Association for the above noted Region.

I hereby certify that:

  • I am a resident of the State of Illinois.

  • I live in, or am a member of an EMS service in the region for which I am running. 

  • I have been a member in good standing of the for at least six months prior to this election as stated in Article 4.6 of the Illinois Emergency Medical Technician Association Guide Lines.


This election shall be held on Sunday morning, March 10, 2018 during the Annual Meeting of the Illinois Emergency Medical Technician Association at Northfield Inn, Suites & Conference Center, Springfield, Illinois. 

This form must be submitted to the IEMTA Board of Directors prior to March 8th, 2019.

© 2019 Illinois EMT Association

Administrator@iemta.com

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