RETIRED MEMBERS GUILD Nomination Form

Check the position for which you are applying

Positions available: 2 NCR Representatives (3 year term)

1 Quebec Representative (3 year term)

1  Prairie/Northwest Territories Representative (3 year term)

Deadline: 12:00 noon Ottawa time – July 31, 2018

CANDIDATE’S NAME

CANDIDATE’S HOME ADDRESS

PHONE NUMBER

E-MAIL

NOMINATED BY:  (MUST BE MEMBERS OF THE GUILD)

NAME (PLEASE PRINT)

SIGNATURE

NAME (PLEASE PRINT)

SIGNATURE

I HEREBY ACCEPT NOMINATION TO THE ABOVE-MENTIONED POSITION

CANDIDATE’S SIGNATURE

Please submit your Candidate Statement of a maximum of 300 words to: