S-4.2, r. 11 - Regulation respecting the election by the public of certain members of the board of directors of a public institution

Schedule Disposition versions

2012-09-01

SCHEDULE II

(s. 11)

PUBLIC ELECTION

Candidate Information Sheet

PHOTO

Institution(s): _______________________________________________________________________

Candidate’s name: ___________________________________________________________________

Municipality of Municipality of

residence: _____________________ workplace: ____________________

Candidate profile (education, occupation, experience):

Reasons for candidacy:

Social, community, volunteer involvement, etc.:

Candidate’s consent: I authorize the disclosure of the information herein as part of the election in which I am a candidate.

____________________ ______________________________

Date Candidate’s signature

____________________ ______________________________

Date Returning officer’s signature

M.O. 2006-016, Sch. II.