ORDRE DES AUDIOPROTHÉSISTES DU QUÉBEC
Nomination paper for election of a director or of president
We, the undersigned, hearing aid acousticians having my professional domicile in the ______________________________ region, propose ______________________________ for the office of director (or of president, as the case may be).
In witness whereof, we have signed at ______________________________ this ____________________ day of ____________________ 20_____
Signatures
I ______________________________, proposed in the above nomination paper, accept the said nomination and solemnly declare that my present conduct is not incompatible with the carrying out of the duties assigned to the board of directors under section 62 of the Professional Code (chapter C-26).
In witness whereof, I have signed at ______________________________ this ____________________ day of ____________________ 20_____
Signatures