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C-26, r. 230 - Regulation respecting elections to the board of directors of the Ordre professionnel des techniciens et techniciennes dentaires du Québec
Schedule
Disposition versions
SCHEDULE I
(ss. 11 and 12)
NOMINATION PAPER FOR ELECTION OF A DIRECTOR IN THE __________________ REGION
We, the undersigned, members in good standing of the Ordre professionnel des techniciens et techniciennes dentaires du Québec, practising our profession principally in the ______________________________ region, nominate as a candidate for the forthcoming election in that region, ______________________________ (name) ______________________________ (address).
_________________________________________________________________________________
| | | | |
| Full name of member | Permit number | Date | Signature of member |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
| | | | |
|________________________|___________________|__________|_________________________|
I, ______________________________, practising my profession principally in the ______________________________ region, nominated in this nomination paper, agree to be a candidate for the office of director for that region.
Enclosed is:
— my curriculum vitae (on one page measuring not more than 22 cm by 28 cm);
— my photograph (measuring not more than 50 mm by 70 mm).
In witness whereof, I have signed at ______________________________, this __________ day of ______________________________ 20__________
__________________________________________
(Signature)
