NOMINATION FORM FOR ELECTED POSITION

Nominations close on July 1st, 2017

Mr. Mrs. Ms.

Nominee’s first name:

Nominee’s last name:

Email:

Phone (including country & area codes):

Fax (including country & area codes):

Full contact address:

Nationality:

Date of birth:

Nomination for which Position: President Treasurer Secretary Member at Large

Please outline recent and current experience in the camp/outdoor field including reference to any international meetings, workshops or conferences connected with camping and outdoor experience (Max : 500 Character):

Statement of intent: Please outline a platform or objectives in serving in the position indicated (Max : 500 Character):

I agree to meet the obligations as outlined for the position: Yes No

Nominator’s first name:

Nominator’s last name:

Nominator’s email:

Please attach a photo (head and shoulders) here (Min : 1000 x 1000)(Optional):

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