FORUM ON PHYSICS AND SOCIETY

2004 ELECTION BALLOT

This is your election ballot.

(You can also vote via a Web Ballot at: http://www.physics.wm.edu/ballot.html)

Information on the candidates appears in this issue of Physics and Society, paper and Web.

Put an X next to the name of the candidates of your choice:

Vice-Chair (vote for one):

Mark Goodman_______

Joel Primack____

____________________(space for write-in candidate)

Secretary-Treasurer (vote for one)

Andrew Post-Zwicker_______

____________________(space for write-in candidate)

Forum Councillor

Phillip (Bo) Hammer__________

Tony Nero________________

____________________(space for write-in candidate)

Members of the Executive Committee (vote for two):

Maureen Mellody______

Rob Nelson_________

Stephen Pierson______

Michael Saunders________

____________________(space for write-in candidate)

Please vote by the www address at http://www.physics.wm.edu/ballot.html

Or fold and tape this self-mailing ballot,

place a stamp on it,

and return it to

Andrew Sessler

so that he receives it no later than September 1, 2003.

The return address is pre-printed on the reverse.

Thank you.

fold here and seal with tape (no staples please)

__________________________________________________________________

fold here

__________________________________________________________________

place

_______________________ stamp

(please print name legibly) here

_______________________

_______________________

_______________________

signature please

Andrew Sessler, Chair

APS Forum on Physics and Society

Lawrence-Berkeley Laboratory

MS71-259

One Cyclotron Road

Berkeley, CA 94720