Community Services Departmental Committee – Call for nominations to vacant positions

Nomination for Delegate

The call for nominations is as follows:

.

Area	Vacant Positions
South West	2

Question Title

* 1. I nominate for the position of delegate for:

South West (Wagga Wagga PSA Office)

Question Title

* 2. We, the undersigned financial members of the above group electorate, nominate:

Candidate's First Name

Candidate's Surname

Membership Number

Candidate's Email

Phone Number

Question Title

* 3. Each nomination must be endorsed by two financial members of the above group electorate.
Please note the nominator and seconder will be sent an email acknowledging their support of the candidate.

Nominator's Membership Number

Nominator's First Name

Nominator's Surname

Nominators Email

Seconder's Membership Number

Seconder's First Name

Seconder's Surname

Seconder's Email

Question Title

* 4. RECEIPT: Acknowledgement of the receipt of your nomination form will be sent to you.

Do you consent to the nomination?

Yes

No