Nomination Form | Interim Councilor (1 Kin, 1 Nursing)

Please submit your completed application in a sealed envelope to the FHSSC Office (HSB 8) by 4.00 pm on Thursday, March 15th, 2012. Name: Student Number: UWO Email: Phone Number: Program (circle): Year:

KINESIOLOGY

NURSING

Candidate Eligibility Candidates must be registered as a full or part time undergraduate student in the Faculty of Health Science at the University of Western Ontario for the 2012-2013 academic year. Individuals running for a position on the Faculty of Health Sciences Students Council cannot serve on a program council (Nursing, Kinesiology or Health Studies Students Council). Nominations Three nominations from students enrolled in the Faculty of Health Science are required for candidacy. Name Student Number Signature

I, _____________________________, verify that the above signatures represent students within the Faculty of Health Science. I will be present at the election meeting on Thursday, March 15th, 2012 at 7.15 pm in HSB Rm. 236. *Note: There will be a meeting for incoming/outgoing Health Science Councilors on Sunday, March 11th, 2012 from 11.00 am 4.00 pm in University College Rm. 213 to interview the USC Vice-Presidential Candidates. Your presence at this meeting is highly encouraged as Councilors will be electing the USC Board of Directors on Sunday, March 18th, 2012. Signature: _________________________________ Date: ________________

Please direct any questions or concerns to president@fhssc.com. Faculty of Health Sciences Students Council Western University, London, Ontario, Canada, N6A 5B9 Arthur and Sonia Labatt Health Sciences Building, Rm. 8 www.fhssc.com | @fhssc