NUS STUDENTS’ SCIENCE

CLUB ELECTIONS
2018/2019
NOMINATION FORM (SCIENCE CLUB
MANAGEMENT COMMITTEE)
CANDIDATE PARTICULARS: Please
insert
Name: ___________________________ *(M/F) photo here
Subject Major: ____________ Year:__________________
Matric no.: ______________ E-mail: ________________
Tel. no.: ________________ Hp no. : ________________

I, __________________, hereby agree to be nominated for the elections of

the 39th Science Club Management Committee.

I *am / am not running for or holding any position in the main committee of
any other student organisation in NUS for the term 2018/2019.

Are you holding a portfolio in any committee of other internal/ external

organisations?
If yes, please specify: ___________________________________

I *am / am not charged by any court or convicted currently.

If yes, please specify: ___________________________________

*Delete where applicable

____________________
Signature & Date
PROPOSER’S PARTICULARS:
Name: _______________________________ *(M/F)
Subject major: _____________________ Year:____________
Matric no. : _______________________ E-mail: _______________________
Tel no. : _________________________ Hp no. : _______________________

I hereby nominate ___________________________ for the elections (co-option) of the

39th Science Club Management Committee.

SECONDER’S PARTICULARS:
Name: _______________________________ *(M/F)
Subject major: _____________________ Year:____________
Matric no. : _______________________ E-mail: _______________________
Tel no. : _________________________ Hp no. : _______________________

I hereby nominate ___________________________ for the elections (co-option) of the

39th Science Club Management Committee.

* Delete where applicable

_______________________ _______________________
Proposer’s Signature & Date Seconder’s Signature & Date

The candidate has been endorsed by the following members of the 38 th Science Club
Management Committee.

1) Full name/ Signature : ________________________________

Portfolio : ________________________________

2) Full name/ Signature : ________________________________

Portfolio : ________________________________

===============================================================

FOR OFFICIAL USE ONLY

Name of Verifying Officer & Signature:
Date: