O-7.2, r. 1 - Regulation respecting the procedure for designating certain members of the board of directors of integrated health and social services centres and unamalgamated institutions

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Schedule V
(ss. 18 and 32.3)
DESIGNATION
Vote Count Report
  
M.O. 2015-005, Sch. V; 2018-002M.O. 2018-002, s. 11.
SCHEDULE V
(Section 18)
DESIGNATION
Vote Count Report
Institution(s): _______________________________________________________
Designation college: __________________________________________________


In accordance with the polling notice, the vote count took place on:


Date: ___________________________________
Time: ___________________________________
Place: ___________________________________

Mail poll:

Envelopes identified: ___________
Envelopes containing no vote envelopes: ___________
Envelopes containing more than one vote envelope: ___________
Vote envelopes counted: ___________
Uncounted vote envelopes: ___________

Poll in person:

Valid ballots: ___________
Rejected ballots: ___________

Candidates Number of votes
(1) __________________________ ______________________
(2) __________________________ ______________________
(3) __________________________ ______________________
(4) __________________________ ______________________
(5) __________________________ ______________________


Signed in __________________________, on____________________________


___________________________________
Signature
______________________________________________________________
Name of designation officer or assistant officer
______________________________________________________
______________________________________________________
Name(s) of scrutineer(s)
M.O. 2015-005, Sch. V.