SP NOMINATION FORM

I, _of _ (Department) hereby express my willingness to serve on the Applied Science and Patent Examination (SP) Group Executive.

Signature: _ Date:  _

Tel: (personal) _ (Work) _

Email: (personal) _(Work) _

Mailing Address: (Work address for Regular Members, Home address for Retired Members)

Please indicate with an “X” the position you are seeking:

_  National Pool (regions outside the NCR)

_  National Capital Region

_ SG PAT

Please indicate your membership status:

_ Regular member

_ Retired member

Each nomination must be supported by five (5) members. The following members in good standing with the Applied Science and Patent Examination Group sponsor me for nomination to the Group Executive (both signature and clearly printed name are required).

Printed Name /  Signature

1.

2.

3.

4.

5.

Candidates are asked to submit a brief résumé of their goals and experience (maximum 200 words) with their nomination. Please note that there will not be a subsequent opportunity to submit or revise the résumé. It is the responsibility of candidates to review their résumés before they are submitted. The résumés will not be proofread and corrections will not be made. They will be inserted into the Elections newsletter as submitted by the candidates. It is recommended, but not mandatory, that résumés be submitted by e-mail to bjolin@pipsc.ca. Candidates should contact Brigitte Jolin at the PIPSC National Office to confirm receipt of their nomination form prior to the deadline. The Elections Committee is authorized to verify any statements of fact made by candidates in their résumés prior to publication. Ballots, if required, will be emailed to members in March.

Completed forms are to be received by email

no later than 12:00 Noon (Ottawa time), March 1st 2018