WECC Member Representative Designation Form

First Name:

Last Name:

WECC Member Organization:

Is this a replacement to the previous Member Representative?

Yes

First Name

Last Name

Is this person still with the organization?

Yes

Should this person be removed from related committee distribution lists?

Yes

Type of Member Representative?

Primary

Alternate

First Name

Last Name

NOTE: WECC Member Representatives should be from the organization's senior-level management.

Title

Telephone:

Email Address: