GEDP XLII 2024 Nomination Form

Please fill out the form below for each nominee for the Governor’s Executive Development Program (GEDP) XLII 2024. You will also need to submit an Organizational Chart and Nomination Letter for each nominee. Email these documents to gcmd@austin.utexas.edu. Submission is not complete until these forms are received.

Participants will be invoiced upon their acceptance into GEDP.

Priority of Nominee (if nominating more than one employee)

Salutation

(Mr./Ms./Dr./Cpt./....)

Nominee First Name

Nominee Last Name

Nominee Nickname:

Nominee Title

Nominee Gov. Agency/University

Nominee Department

Preferred Mailing Address

City/Town

State

ZIP Code

Nominee Phone

(ex. 512-555-1212)

Nominee Alternate Phone

Nominee Email Address

Separate multiple email addresses with commas.

Nominee Assistant/Administrator's Email Address

Separate multiple email addresses with commas.

Email Address for Invoice

Separate multiple email addresses with commas.

Purchase Order #

OPTIONAL/NOT REQUIRED

Nominator's Salutation

(Mr./Ms./Dr./Cpt./....)

Nominator's Name

Nominator's Phone

(ex. 512-555-1212)

Nominator's Email Address

Separate multiple email addresses with commas.

Nominator's Assistant's Name

Nominator's Assistant's Phone

(ex. 512-555-1212)

Nominator's Assistant's Email Address

Separate multiple email addresses with commas.

Course Code