DÚN LAOGHARIE–RATHDOWN COUNTY

COMMUNITY & VOLUNTARY FORUM

 

Nomination Form for Election to the

Joint Policing Committee

(BLOCK CAPITALS PLEASE)

 

 

I ______________________Chairperson/Secretary

of ______________________________(group/organisation)

Hereby authorise the person named below to stand for election to the Joint Policing Committee for the local authority area of Dún Laoghaire-Rathdown. We understand and accept the eligibility criteria as set down by the Community and Voluntary Forum.

 

Person nominated to stand for election

 

Name: ________________________________________

Address: _______________________________ ______________________________________ ______________________________________ ______________________________________

Tel: ___________________ Mobile: _________________

E-mail: ________________________________________

 

Signed by nominee: _____________________Date: __________

 

 

Contact Details of Group/Organisation:

Contact Person: ______________________________________

Address: ___________________________________________

               ___________________________________________

               ___________________________________________

Tel: ___________________ E-Mail: _______________

 

Signed by Nominating Group/Organisation___________________

 

 

The Nomination Form, should be returned to:

(or cut and paste into a WORD doc. and E-Mail to wmorton@dlrcoco.ie before the closing date)

 

Community and Voluntary Forum

C/O Economic Development & Community Department,

County Hall,

Marine Road,

Dún Laoghaire

 

on or before 12noon, on Monday, 23^rd February, 2009.