Nomination Form Bbe[1]

CONFIDENTIAL

PEOPLE’S ASSOCIATION YOUTH MOVEMENT NOMINATION FOR YOUTH EXECUTIVE COMMITTEE NNote:

PHOTO

1. This form will take you about 5 minutes to complete. 2. Please submit the completed form to the CO staff of the community centre/club from 5th to 20th August 2009.

PARTICULARS OF PROPOSER/SECONDER We nominate ___________________________________ for election to the Executive Committee of the Youth Group of _________________________________________________ Community Centre/Club. PROPOSER Name______________________________ NRIC No. __________________________ Address____________________________ ___________________________________ ___________________________________ ___________________________________

SECONDER Name______________________________ NRIC No. __________________________ Address ____________________________ ___________________________________ ___________________________________ ___________________________________

Signature___________________________

Signature___________________________

PARTICULARS OF CANDIDATE Name as stated in NRIC Nationality _________________________ ____________________________________ NRIC No. __________________________ Date of Birth _________________________ Tel No. ____________________________ Race________________________________ Marital Status _______________________ Occupation___________________________ Gender_____________________________ Address ________________________________________________________________________ _______________________________________________________________________________ I accept the nomination for election. I declare that I have no criminal record and am free from financial embarrassment. _____________________________ Signature

_______________ Date FOR OFFICIAL USE

Adviser’s Remarks   ____________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Date_________________________                                            Signature__________________________ Chief Executive Director’s Remarks _______________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Date_________________________                                            Signature__________________________

PA/YM/01/2001