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Nominate Yourself

As a citizen of Illinois, you are invited to use the form below to nominate yourself for membership on up to four boards, commissions, councils, or task forces. The information we collect will be used by the Governor's office in considering your interest in an appointment. It will be kept confidential and protected from disclosure to the extent permitted by law. If you have problems completing the form, please email gov.appointments@illinois.gov.

 

required Required Fields. Please provide accurate information in ALL required fields.

 

Application for Gubernatorial Appointment

Other Name ChoiceHave you ever used or been known by any other legal name?
Other Name Choice
e-Newsletter SubscriptionSign up for a Governor's e-Newsletter Subscription
e-Newsletter Subscription
Nominee Gender required
Nominee Gender
Ethnicity required
Ethnicity
Disability Choice requiredDo you have a disability?
Disability Choice
Veteran ChoiceAre you a Veteran?
Veteran Choice
Registered VoterAre you a registered voter?
Registered Voter
Public Official ChoiceAre you a public official?
Public Official Choice
Spouse Public Official ChoiceIs your spouse / domestic partner a public official?
Spouse Public Official Choice
Lobbyist ChoiceAre you a lobbyist registered with the Sate of Illinois?
Lobbyist Choice
Spouse Lobbyist ChoiceIs you spouse / domestic partner a lobbyist registered with the State of Illinois?
Spouse Lobbyist Choice
Government Employee ChoiceAre you a government employee?
Government Employee Choice
Spouse Government Employee ChoiceIs you spouse / domestic partner a government employee?
Spouse Government Employee Choice
Certification
Certification