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CALIFORNIA FEDERATION BUSINESS AND PROFESSIONAL WOMEN’S CLUBS

                                       STATE ELECTIVE OFFICE CANDIDATE


                                              CONSENT TO SERVE FORM


               1.  A CLUB SPONSORING a candidate for state elective office is to complete the first portion
                   of this form and return to the State Nominations Chair
               2.  A CLUB ENDORSING the candidate may use the first part of this form (exclusive of the
                   Consent to Serve)

                * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
                                         CLUB ENDORSEMENT OF CANDIDATE

               NAME OF CANDIDATE: _______________________________________________________
               (Please print)
               OFFICE FOR WHICH BEING ENDORSED: ________________________________________

               SUBMITTED BY: _________________________________CLUB

               A MEMBER OF __________________________________ DISTRICT

               PLACE OF MEETING ________________________________    DATE __________________

               SIGNED CLUB PRESIDENT _____________________________________________________

               SIGNED CLUB SECRETARY ____________________________________________________

               * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

               CANDIDATE CONSENT TO SERVE:

               I, _________________________________________________, agree to serve as
               ___________________________________________________ if elected by the State
               Conference body.  I pledge to uphold the California BPW Public Policy Statement and am
               willing to furnish information necessary for bonding.

               Signed: ______________________________________            Date: ________________________

               * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
               RETURN TO:
               Manjul Batra
               CFBPW Nominations Chair
               3386 Whitehaven Drive,
               Walnut Creek, CA 94598

               Questions?: 510-612-4934  manjulbatra1@gmail.com
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