JAMES COOK UNIVERSITY
COUNCIL ELECTION - BY AND FROM THE STUDENTS OF JAMES COOK UNIVERSITY
NOMINATIONS CLOSE 4.00 PM ON FRIDAY 28 FEBRUARY 2020
NOMINATION PAPER
We, the undersigned, being students at James Cook University, hereby nominate:
FAMILY NAME: _________________________________ TITLE: (Mr, Ms, Dr, etc): ___________
GIVEN NAMES: _________________________________ STUDENT NUMBER: ___________
(Please print in block letters)
for office of student member of the Council of the James
Cook University.
Dated the ____________________________ day of ___________________________ 2020.
NAMES OF NOMINATORS SIGNATURES OF NOMINATORS STUDENT
(Please print in block letters) NUMBERS
1. _________________________ ___________________________ ______________
2. _________________________ ___________________________ ______________
3. _________________________ ___________________________ ______________
I consent to this nomination.
I understand that, by indicating a wish to become a student member of the governing body of
James Cook University, I will be asked to authorise a criminal history check on my background by the
Queensland Police Service and required to obtain and maintain a Blue Card. I further understand that
such checks represent standard practice when considering membership of Boards and authorities
governed by State legislation.
SIGNATURE OF NOMINEE:
CURRENT PLACE OF
RESIDENCE OF NOMINEE:
(Please print)
E-mail: _____________________ Tel Number: _______________ Date: ___________________
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This Nomination Form must be returned to the University Secretary (Returning Officer), James
Cook University, QLD 4811, by 4.00 pm on Friday 28 February 2020. Forms can be emailed to
secretariat@jcu.edu.au
or delivered by post or hand to the Secretariat, Room 307, Ken Back
Chancellery Building, James Cook University, Townsville QLD 4811. The nominee should also
complete a Biographical Details form.
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I, the undersigned, hereby certify that I received this nomination at ___________________________
on ______________________________ and that it is in order.
________________________________________
University Secretary
Date: / /
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