Association of the Chemical Profession of Ontario - Nomination Form

District Councillor Elections

Candidate Nomination Form

To the ACPO Secretary:

We, the undersigned members (3 required), hereby nominate
(Please print)

_____________________________________________

as a candidate for election as Councillor to represent Electoral District No. ____
for the two-year term commencing in the current year.

Nominating Committee:

	(1) ___________________________	(2) ___________________________

	(3) ___________________________

I agree to serve the appointed term of office, if elected to the above position.

	(Nominee)	_________________________________
	Date:	_________________________________

Nominations must reach the Secretary of the Association no later than April 15^th of the year in which the term begins. Please mail or fax this form to:

1 Yonge Street, Suite 1801
Toronto, Ontario
M5E 1W7
Fax: 416-369-0515

______________________
(Download a PDF version of this form)