Nomination Form Secretariat Rep

1

Terms And Conditions

I am a member of a group registered with Waterford PPN
Waterford PPN is non political, I agree as a representative to abide by this ethos in its entirety
I understand and will adhere to the role and responsibilites of the position as stated in the PPN Constitution and the Representatives Charter (copies attached to email)
I am aware that Elections may take place post Nomination process
I have the authorisation of my group/organisation to submit this Nomination and I understand that they will be contacted to confirm.

2

I agree to the Terms and Conditions as stated on Previous Page* This field is required.Nomination is only valid if you agree to the terms and conditions

YESNO

3

Name* This field is required.

First Name

Last Name

4

Email* This field is required.

example@example.com

5

Phone Number

Home

Mobile

6

Name of the PPN Organisation you are a member of that is nominating you* This field is required.

7

Please tell us briefly why you are applying for the position (MAX 150 words)* This field is required.

8

Declaration * This field is required.I understand and agree that the data given on this form will be held and used by Waterford PPN in relation to the 2019 PPN Elections.

YESNO

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