NRC-RO/RCO - Nomination form 2018

NOMINATION FORM FOR 2018

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The following RO/RCO Regular Members nominate: Candidate’s name (printed)

as: (Please specify one or both)

A member of the RO/RCO Group Executive

and/or

A Location/Building representative for Location address

Name / PIPSC Member# / Signature / Date

1.

2.

3.

I, Candidate’s name (printed), hereby accept the nomination.

Candidates signature

PIPSC Member #

Date

Location/Building

Phone No.