NOMINATION FORM

To register as a candidate fill out form and email to head office at trinbarjamelections21@gmail.com.

First Name: Enter here

Surname: Enter here
Sex: Choose here

Date of Birth:
Profession: Enter here
Address: Enter here
Email: Enter here
Contact: Enter here
What is your constituency? Choose here

What party are you in? Choose here

Date : Candidate Signature: Enter here

Trinbarjam Elections 21