Nominate Yourself

Why this information is collected?

As a resident of Illinois, you are invited to use the form below to nominate yourself for membership on Illinois boards, commissions, committees, councils, and task forces. The information collected will be used by the Governor's Office in considering your interest and qualifications for appointment. If you have problems completing the form, please email gov.appointments@illinois.gov.

The Governor's Office does not discriminate on the basis of sex, race, color, religion, gender identity, sexual orientation, national origin, age, military or veteran status, disability or any other characteristic protected by law. The demographic information collected will not be used in a discriminatory manner.

Per 15 ILCS 50/25, the Office of Gubernatorial Appointments is required to collect demographic information on applicants and appointed members. As such, the demographic information you may choose to provide will be utilized for this express purpose, and it will be kept confidential and protected from disclosure to the extent permitted by law. Your participation is completely voluntary

 

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

 

 Application for Gubernatorial Appointment

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