Local 5621 HPAE Officer Nomination Form - Health Professionals & Allied Employees

Local 5621 HPAE Officer Nomination Form

The Nominations/Election Committee announces that there are five (5) officer positions up for election this year.  The officer positions are President, Co-Vice Presidents, Secretary, Treasurer. Nominations for these positions are currently being accepted by the nomination committee.


  • President
  • Vice President
  • Secretary
  • Treasurer
  • Grievance Chairperson

(Job descriptions can be found on the back of this form.)

TERM OF OFFICE: September 1, 2023 through August 31, 2025

NOMINATIONS PROCEDURE: A member in good standing may nominate another member to run for office. To nominate a candidate, a member must submit a nomination form to the Elections Committee with candidates signature accepting nomination. A member may also nominate themself for office. Said nomination forms must be submitted no later than the timeline set forth in the Notice of Election. A member may not nominate more than one candidate for the same position. A member may not be a candidate for more than one position.  Attached you will find a Nomination notice and form.  Return completed form to Local 5621 Nominations and Elections, P.O. Box 119, Emerson, New Jersey 07630 or emailed to Localelections@hpae.org .  Union office phone number (201) 262-5005.  Candidates must confirm receipt of nomination from a committee member by the deadline.  If not confirmed, the committee cannot guarantee name will appear on ballot.


NOMINATIONS DEADLINE: Forms must be received by August 9, 2023 – 10:00 a.m.  All forms received late will be void

ELECTION INFORMATION: Ballots to be mailed to all members in August. If it is an uncontested election, the committee will cast one ballot on behalf of the slate in which case no ballots will be sent. All candidates may examine membership list and be present for the mailing and counting of the ballots.  You must advise the committee in writing if you wish to be present or would like to view membership list.  The reason for this is they will then share all the necessary information such as place and time.  Candidates must abide by “rules of conduct” establish by committee. If any candidate does not receive the rules of conduct, please contact a committee member.

ELIGIBILITY: Any HPAE Local 5621 member in good standing is eligible to run for office . All candidates elected must attend the HPAE Officer training  Nomination/Election Committee members are not eligible to run for office.

HPAE LOCAL 5621 NOMINATIONS/ELECTION COMMITTEE: Sharon Heath, Ernestine Wing, Jennifer Browning and Jeffrey David Ball, jball@hpae.org  (HPAE Staff Representative)