NOMINATION FORM
Board of Governors Support Staff Assessor 2019 – 2021
WE: (name and signature of five support staff members making the nomination)
Name Signature
1.
2.
3.
4.
5.
NOMINATE: (Nominee
=
s Name)
(Title)
(Department)
to serve as Support Staff Assessor on the Board of Governors.
I, accept the nomination.
(Nominee’s name)
SIGNED: DATE:
(Signature of the Nominee)
Please provide a short paragraph of factual information about the Nominee which will
appear on the ballot provided for voting: [a separate sheet may be attached if more space required]
Please submit completed form to the Office of the University Secretary
at 312 Administration Building or to Sandi.Utsunomiya@umanitoba.ca