(BLOCK CAPITALS PLEASE)
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
Address: _______________________________ ______________________________________ ______________________________________ ______________________________________
Tel: ___________________ Mobile: _________________
Signed by nominee: _____________________Date: __________
Contact Details of Group/Organisation:
Contact Person: ______________________________________
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 email@example.com before the closing date)
C/O Economic Development & Community Department,
on or before 12noon, on Monday, 23rd February, 2009.