Appendix D

National Executive Council by-election 2016

Nomination form

Cymru/Wales Female seat

  • Nominating bodies who wish to nominate candidates in the above election must complete this form.
  • If you submit this form by email or fax, the original signed paper copy must reach us by the deadline laid out in the timetable.
  • All boxes must be completed. Incomplete forms may be returned and this may deem the form invalid.
  • Paper copies must be completed in black ink.
  • Forms may be downloaded from the UNISON website at or requested from the Member Liaison Unit, telephone 0207 121 5399
  • Prospective candidates must sign and submit a candidate form (appendix B) to confirm they are willing to accept nominations in this election

Nominating body information
Region: Cymru/Wales
Name of branch
Branch code / Nominating body telephone number
Nominating body postal address
Nominating body email address
Meeting information
  • Any physical or online (virtual) meetings held to nominate candidates must take place during the nomination period laid out in the timetable
  • Branches whose approved branch rules allow online meetings may make a decision to nominate candidates using electronic means
  • All meeting information must be included
  • Types of acceptable meetings are branch and committee meetings

Was the meeting physical or online? / PHYSICAL MEETING / ONLINE MEETING
Number of members at physical meeting? / Or number of members involved in online meeting decision?
What is the quorum for this meeting (how many members necessary to conduct business)? / Was this meeting quorate? YES NO
Meeting date / Meetings must be held between 19 April – 20 May 2016
Type of meeting
(e.g. branch, committee)
Meeting venue
Candididate information
Only branches in Cymru/Wales region may nominate this seat
Cymru/Wales Female seat
Name of candidate: / RMS number (if known):
Branch certification
  • This nomination is made in accordance with the rules of UNISON and the election procedures for this election.
  • Names and membership numbers of the branch secretary and chairperson must correspond with those recorded on the RMS
  • Where only one post is filled, we require the signature of another branch officer, i.e. 2 signatures are needed.

Secretary’s name: / RMS number:
Secretary’s signature: / Date:
Chairperson’s name: / RMS number:
Chairperson’s signature: / Date:
Please provide an explanation if this form has been endorsed by a branch officer other than the branch secretary or chairperson listed on the RMS.
This form can be submitted by
PostMember Liaison Unit, UNISON, The UNISON Centre, 130 Euston Road, London, NW1 2AY
. Fax0207 121 5196
Deadline for receipt of nomination forms is 5pm, 20 May 2016.
Where this form is submitted by email or fax, the original signed paper copy must be received by the Member Liaison Unit by 5pm, 27 May 2016.

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