NSW TEACHERS FEDERATION

2012 Election of Councillors

for the 2013-2014 Biennium

Nomination Form

A COMPLETED NOMINATION FORM MUST BE RECEIVED BY THE RETURNING OFFICER, MR NEALE DAWSON, SOLICITOR, NOT LATER THAN NOON, WEDNESDAY 5 SEPTEMBER 2012. IT MAY BE HAND DELIVERED TO FEDERATION LAW, LEVEL 4, TEACHERS FEDERATION HOUSE, 23-33 MARY STREET SURRY HILLS, POSTED TO LOCKED BAG 3009, DARLINGHURST NSW 1300 OR FAXED TO (02) 9217 2430.
CANDIDATE DETAILS
Full Name of Candidate:
Full Residential Address:
Date of Birth
Phone: / Home: Work:
Mobile:
Email:
Name of School/College
Serial No.
Association Nominated For:
NOMINATORS DETAILS
Full Name of Nominator:
Full Residential Address:
Serial Number:
Signature:
Full Name of Nominator:
Full Residential Address:
Serial Number:
Signature:
Full Name of Nominator:
Full Residential Address:
Serial Number:
Signature:

NOTE: This nomination must be made by at least two (2) financial members of the Association concerned.

No person may nominate more candidates than the number to be elected.

Rule 5.3.1. of the Federation Rules states that: "Association representatives to Council must be members of the Association or, in the case of grouped Associations, one of the Associations they represent."

CANDIDATE’S CONSENT
I hereby consent to the nominationand declare that I am a financial member of the NSW Teachers Federation.
My name should appear on the ballot paper as: ______
Surname(One) Given Name
Only one given name and surname will appear on the ballot paper. Recognised abbreviations or derivatives of given names are acceptable, but nicknames are not.
______
(Signature of Candidate) (Date)

Statutory Declaration in Support of Candidature

NSW TEACHERS FEDERATION

2012 ELECTION OF COUNCILLORS FOR THE 2013-2014 BIENNIUM

The information you provide in the box below should be no more than 400 words. You may type your statement onto the form below or type it and affix it within the box.

As well, you are asked to provide a word file as an attachment to an email sent to , marked to the attention of the Returning Officer. This file should be typed in no less than a 10 point font. Itwill be used to print your candidate statement on information sheets provided to voters.

I,______

(Full name)(Residential address)

do solemnly and sincerely declare the following in support of my candidature.

NAMNAME:______POSITION SOUGHT:______
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And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the

Oaths Act, 1900. Declared at this day of 2012.

______ in the presence of an authorised witness, who states :

(Candidate’s Signature)

I, …………………………………………………… , a JP for NSW …………………..…………………………….. , certify:

[full name of JP][date]

  1. *I saw the face of the declarant/deponent OR *I did not see the face of the declarant/deponent because he/she was wearing a face covering, but I am satisfied that he/she had a special justification for not removing it, and
  2. *I have known the person for at least 12 months OR *I have confirmed the person’s identity with ……………………………......

______

[Signature of Justice of the Peace]

Candidates wishing to submit a Statutory Declaration should lodge the completed form with the Returning Officer, Mr Neale Dawson, Solicitor. They may be hand delivered to Federation Law, Level 4 Teachers Federation House, 23-33 Mary Street Surry Hills, posted to Locked Bag 3009, DARLINGHURST NSW 1300, or faxed to (02) 9217 2430 not later than:NOON, WEDNESDAY 5 SEPTEMBER, 2012.