PETITION FORM FOR HAND SIGNATURES

PETITION FORM FOR HAND SIGNATURES For hand-inscribed signatures via paper or facsimile to be valid, the following information must be included: I / We, the undersigned member(s) of the American Chemical Society, hereby nominate ___________________________ for the office of _________________________ for the election being held in the year of __________ as a petition (candidate/nominee).

Signature

PRINT NAME CLEARLY

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