NOMINATION PAPER FOR ELECTION OF A PRESIDENT
We, the undersigned, members in good standing of the Ordre professionnel des techniciens et techniciennes dentaires du Québec, nominate as a candidate for the forthcoming election of a president of the Ordre professionnel des techniciens et techniciennes dentaires du Québec, ______________________________(name), ______________________________ (address).
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| Full name of | Permit | Address of the | Date | Signature |
| member | number | place where | | of member |
| | | member principally | | |
| | | practises profession | | |
|_________________|___________|_________________________|__________|______________|
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|_________________|___________|_________________________|__________|______________|
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|_________________|___________|_________________________|__________|______________|
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|_________________|___________|_________________________|__________|______________|
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|_________________|___________|_________________________|__________|______________|
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|_________________|___________|_________________________|__________|______________|
I, ______________________________, nominated in the above nomination paper, agree to be a candidate for the office of president of the Ordre professionnel des techniciens et techniciennes dentaires du Québec.
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__________
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(Signature)