Nomination Form Council Member Candidate
STEP 3 – Candidate Consent
Type or print only:
I consent to allow my name to stand for election for Council Member.
( this information will not be shared with others)
Name:
District #:
CPSO Number:
Please email your application or
submit it through the College website:
http://www.cpso.on.ca/
councilelections
Signature:
Home Tel.:
DEADLINES FOR
NOMINATION FORMS
Business Tel.:
Street Address:
Email: [email protected]
Forms must be received by 4:00pm
Tuesday, August 27, 2019.
City/Province/Postal Code:
STEP 4 – Nominators
To stand for election, you must be nominated by five members of the College who are: eligible to vote in the district in
which you are being nominated; not in default of payment of fees owed to the College and who have a license that is not
under suspension or revoked. We recommend that seven nominators be provided in the event that a nominator does not
meet these criteria.
We the undersigned members who meet the eligibility criteria identified above, nominate the above-named candidate
for election:
Print Name Signature CPSO Number
1.
2.
3.
4.
5.
6.
7.
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DIALOGUE ISSUE 2, 2019