NEA Statewide Delegate Nomination Form

Nomination for election to serve as a Kentucky delegate to the NEA Representative Assembly,
July 2 to July 6, 2022 in Orlando, Florida.

You may submit a photo to be posted with your biographical information; photos submitted electronically
should be in “jpeg” format and must be submitted with this form.

This completed form must be received in the KEA office by 5:00 pm (Eastern Time) on Tuesday, January 17, 2023 in order for you to be listed on the official ballot.

Late received forms will not be accepted.