2017NOMINATION FORM

FOR OFFICE ON THE PROVINCIAL EXECUTIVE

Application Deadline: 4:30 p.m., Eastern Standard Time, August 31, 2017

Name:

Address:

City/Prov/Postal Code:

District Number and Name:

Tel:( ) ______Fax: ( ) ______Email:

In accordance with the Provincial Constitution, Bylaws and Policies, I declare that I am a Full member of RTO/ERO and that I have been nominated for the position of:

PresidentSecond Vice-President

First Vice-PresidentExecutive Member

Signature of Nominee:Date:

Approved by District/Unit ,at a District/Unit Executive Meeting held

on (date)

Signature of District/Unit President:Date:

Signature of District/Unit SecretaryDate:

(A condition of applying for service as a member of the Provincial Executive is agreement to stay at hotels designated by RTO/ERO when attending meetings.)

1.I consent to the collection, use and disclosure of the information in this form for the purposes deemed appropriate and necessary by the Nominating Committee of RTO/ERO.

2.I declare that neither I nor a member of my immediate family has any material interest nor is liable to any financial or other gain as a result of my participation in the business of the RTO/ERO body for which I am being nominated. Further, I will declare immediately any such interest should it arise subsequent to my appointment or election.

3.I herewith disclose the name of the Insurance Plan in which I am enrolled:

______RTO/ERO Group Benefits Program (administered by Johnson Inc.) or

______Other – please provide the name: ______

I have read all of the above, and, by my signature, attest to the fact that I consent and declare to all that has been requested. Furthermore, and by my signature, I confirm that the information disclosed is true.

Signature of Applicant

Date:

Please complete and provide the necessary documentation using the Guidelines printed on the following page and send to the Executive Director by August 31, 2017.

GUIDELINES

a)Nominations must be approved by resolution at a District or Unit Executive meeting,

b)Nomination forms must be signed by both the District or Unit President and District or Unit Secretary,

c)Nominee must sign and date the CONSENT and DECLARATION,

d)The Nomination Form must be received by the Executive Director by August 31, 2017

e)You may also submit a statement and a curriculum vitae by August 31, 2017to be included in the File of Reports to be sent out prior to Senate.

f)A statement of 250 words or less may be submitted in support of the nomination. This statement may include:

  • length of teaching service;
  • teaching related experience (Administrative, Supervisory, Professional organizations);
  • service with RTO/ERO at the District/Unit or Provincial level;
  • service with other voluntary organizations; and,
  • attributes you have that would make you an effective member of the Provincial Executive.

g)A copy of your Curriculum Vitae.

NOTE

Further Nominations may be received from the floor at Senate in accordance with the

Provincial Constitution, Bylaws and Policies - Bylaw 5, Section 1 (b).

A candidate’s expenses will be covered by the Provincial Office only if the candidate is already eligible to attend Senate.

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