Branch: ................................... Ref: 014/ .....................................
Mr/Mrs/Miss/Ms
Name ..................................................................................................
Nominee's branch ..............................................................................
Mr/Mrs/Miss/Ms
Name ..................................................................................................
Nominee's branch ..............................................................................
Mr/Mrs/Miss/Ms
Name ..................................................................................................
Nominee's branch ..............................................................................
Mr/Mrs/Miss/Ms
Name ..................................................................................................
Nominee's branch ..............................................................................
Please insert title, name and nominee's branch -
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8)
Please insert title, name and nominee's branch -
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2)
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Please insert title, name and nominee's branch -
1)
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Please insert title, name and nominee's branch -
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We certify that in accordance with Clause 10 of the election regulations, all the above nominations have been passed at a properly constituted meeting of the members of the Branch held at:
.................................................... on .....................................................
(location) (date)
Signed: ....................................................... (Branch Chair)*
Signed: ....................................................... (Branch Secretary)*
Branch: 014................ Date: ..................................................................
*If the Branch chairperson or secretary is absent then the form can be signed by another branch officer. Any alterations or deletions to the nomination forms must be authenticated by the signatures of the branch chairperson and secretary (or, if either is absent, by another branch officer).
Branch secretary's contact address .........................................
................................................................................................................
Telephone Number .........................................................
IMPORTANT: This form must be returned to:MOD Group Secretary, PCS HQ, 160 Falcon Road, London SW11 2LNby:5pm on Thursday 4 March 2010. This form may be faxed (fax no 020 7801 2620). Please bear in mind that this fax machine will be very busy at this time.