75th ORC - Nomination Form

NOMINATION FORM

POSITION FOR
NOMINATION:  ONTARIO REGIONAL EXECUTIVE
NAME OF NOMINEE:
ADDRESS:

E-MAIL
TELEPHONE:                           
[home]
[work]
BRANCH:
GROUP
 

I hereby accept this nomination for the above position.

SIGNATURE:
DATE:
NOMINATED BY:

Nominees may attach a brief resume of their qualifications and experience.
Nominees must be a member in good standing (not a rand).