CFIA S&A Group Nomination Form 2018

Canadian Food Inspection Agency Scientific and Analytical Group NOMINATION FORM 2018

Election of the two (2) members-at-large from the National Capital Region

I,(PRINT NAME), hereby submit my nomination for the position of member-at-large
        
from the National Capital Region on the Canadian Food Inspection Agency Scientific and Analytical Group Executive.

Date    
Signature    
Membership #

PLEASE INDICATE CLEARLY YOUR REGION

Atlantic:     
BC/Yukon:         
Ontario:
National Capital:    
Prairie/NWT:        
Québec:

Tel.: Work         
Tel.: Home

Email: Work
Email: Home

Home address

The following members in good standing from the Scientific and Analytical Group endorse my nomination to a Group Executive position. Their signature and name in block letters are below.

ENDORSED BY:

Name    
Signature    
Membership #

ENDORSED BY:

Name    
Signature    
Membership #

ENDORSED BY:

Name    
Signature    
Membership #

ENDORSED BY:

Name    
Signature    
Membership #

ENDORSED BY:

Name    
Signature    
Membership #

A biographical sketch of not more than 200 words setting out your objectives and experience must be submitted electronically to dlanthier@pipsc.ca by the deadline date (November 7, 2018 at 12:00 pm) for inclusion in the kit if an election is required.

Please note that it is the responsibility of candidates to review their bios before they are submitted. The bios will not be proofread and corrections will not be made except when requested by the Elections Committee. They will be inserted into the Elections newsletter as submitted by candidates.