NOMINATION FORMTO SERVE ON THE UK REGIONAL BOARD2017

SECTION A: Nomination

We the undersigned, being registered Member of The Chartered Institute of Management Accountants do hereby nominate:

Name: (in full): ______

Please print in block letters

CIMA Contact ID number:______

Registered address: ______

______

as a fit and proper candidate (Regulation IV.13) for election to the UK Regional Board of the Chartered Institute of Management Accountants.

DETAILS OF NOMINATORS (Members only)

1 Name: (in full): ______

Please print in block letters

Registered address ______

Signature: ______CIMA Contact ID number:______

2 Name: (in full): ______

Please print in block letters

Registered address: ______

Signature: ______CIMA Contact ID number:______

SECTION B: Resumė

Please attach a biographical summary (resume) of the nomineeincluding achievements with CIMA as well as career achievements. This should be no longer than 200 words. If this number is exceeded a précis will be used. Statements that give the impression of ‘electioneering’ or ‘canvassing’ are not permitted. CIMA reserves the right to edit any statements that are deemed electioneering or canvassing. An up-to-date digital photo should also be supplied. In the event of an election, the digital image, this biographical summary and the names of the nominators will be used for the electronic ballot paper.Please submit the resumė by email

SECTION C: Declaration to be signed by the nominee:

I ______, the undersigned being a member of the Chartered Institute of Management Accountants, hereby confirm the foregoing particulars are correct and declare that I consent to stand as a candidate for election to the UK Regional Board of the Institute and that I undertake to promote the interests of the Institute to the best of my ability.

In particular I undertake to:

  • attend at least the majority of meetings of the Board
  • complete any special work that may be delegated to me by the Board.

Signature: ______Date: ______

Checklist

 Form signed by two nominators

 Form signed by nominee

 Resumė (not to exceed 200 words)

 Electronic passport size photo, format Jpeg or Tif

Returning the form

On completion, this form must be returned toPaul Greenaway, CIMA,The Helicon, 1 South Place, London EC2M 2RB either by post/email(scanned original with signatures) and reach the office not later than 1.00pmon22 May 2017.

Forms that are received after the deadline will not be accepted.

Important notice:

A scanned copy of the form is acceptable. In order to avoid uncertainty it is recommended that, if candidates do not receive confirmation that their nomination form has been received and is being processed, they contact the Manager, CIMA Events Europe, CIMA UK directly tel: +44 (0) 20 38142440 / email: BEFORE the closing date, to actively seek such confirmation.